The RN Case Manager will work with a defined patient population in the Emergency Department to facilitate the correct status designation of "place into observation" (OBS) or "admit into inpatient". This position will promote optimal clinical outcomes and resource utilization to insure that all patients are placed in the correct bed status, using approved clinical criteria Indicia (MCG) and InterQual Clinical Criteria. The RN Case Manager will work in collaboration with the ED physicians as well as the Patient Access staff to correctly enter the patient's status for accurate billing and required payor authorization/notification. This position will enable the Cook Children's Medical Center to enhance efficiencies, enhance hospital reimbursement and reduce potential payor denials and underpayments.
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