The RN Case Manager uses a collaborative process to plan, assess, implement, monitor and evaluate the options and services required to meet the healthcare needs of patients using the functions of Utilization Review using InterQual and Milliman Care Guidelines, Discharge Planning and Case Management in order to facilitate: (1) quality of patient care; (2) cost effective utilization and outcome management; (3) communication between patients, families, and members of the health care team; (4) expedition of the movement of patients through appropriate levels of care; and (5) information gathering for Quality & Risk Management utilizing Joint Commission Accreditation of Healthcare standards and clinical indicators. The Case Manager will assist with the identification of appropriate providers and facilities throughout the continuum of care, to ensure that resources of both CCMC and the patient are used in a timely and cost-effective manner to meet the healthcare needs of the patient.
Graduate of an accredited nursing program
Current Texas RN license required
Minimum of three years of clinical experience required
CPR - BLS required within 30 days of start
Previous experience in case management/utilization review preferred