Job Category: Support/ClinicalDegree Level: Associate's Degree/College Diploma (±13 years)Job Description:St. Francis Hospital MemphisSaint Francis Hospital Memphis is a 510-bed acute care hospital dedicated to providing high quality, compassionate care to the Mid-South community. As a comprehensive medical center, Saint Francis Hospital Memphis features a broad spectrum of tertiary and acute care, outpatient services and specialty areas including Women's Services, Surgical Services, Bariatric Center of Excellence and Behavioral Health. Other acute care areas include Emergency Room, Critical Care, Med/ Surge and Telemetry.RN Case Manager I Full Time Days Position SummaryThe RN Case Manager is responsible to facilitate care along a continuum through effective resource coordination to help patients achieve optimal health, access to care and appropriate utilization of resources, balanced with the patient's resources and right to self-determination. The individual in this position has overall responsibility for ensuring that care is provided at the appropriate level of care based on medical necessity and to assess the patient for transition needs to promote timely throughput, safe discharge and prevent avoidable readmissions. This position integrates national standards for case management scope of services including:Utilization Management supporting medical necessity and denial preventionTransition Management promoting appropriate length of stay, readmission prevention and patient satisfactionCare Coordination by demonstrating throughput efficiency while assuring care is the right sequence and at appropriate level of careCompliance with state and federal regulatory requirements, TJC accreditation standards and Tenet policyEducation provided to physicians, patients, families and caregiversResponsibilitiesThe individual's responsibilities include the following activities:Accurate medical necessity screening and submission for Physician Advisor review,Care coordination;Transition planning assessment and reassessmentImplementation or oversight of implementation of the transition planLeading and facilitating multi-disciplinary patient care conferences,Managing concurrent disputes,Making appropriate referrals to other departments,Identifying and referring complex patients to Social Work ServicesCommunicating with patients and families about the plan of careCollaborating with physicians, office staff and ancillary departmentsLeading and facilitating Complex Case ReviewAssuring patient education is completed to support post-acute needsTimely complete and concise documentation in Case Management systemMaintenance of accurate patient demographic and insurance informationIdentification and documentation of potentially avoidable daysIdentification and reporting over and underutilization;Other duties as assignedEducationRequired: Graduate of an accredited school of nursing.Preferred: Academic degree in nursing (bachelor's or master's)ExperienceRequired: 2 years of acute hospital patient care experience.Preferred: Acute hospital case management experience.CertificationRequired: RN. Must be currently licensed, certified or registered to practice profession as required by law or regulation in state of practice or policy. Active RN license for state(s) covered.Preferred: Accredited Case Manager (ACM)About Us: Who We AreWe are a community built on care. Our caregivers and supporting staff extend compassion to those in need, helping to improve the health and well-being of those we serve, and provide comfort and healing. Your community is our community.Our StoryWe started out as a small operation in California. In May 1969, we acquired four hospitals, some additional care facilities and real estate for the future development of hospitals. Over the years, we've grown tremendously in size, scope and capability, building a home in new markets over time, and curating those homes to provide a compassionate environment for those entrusting us with their care.We have a rich history at Tenet. There are so many stories of compassionate care; so many "firsts" in terms of medical innovation; so many examples of enhancing healthcare delivery and shaping a business that is truly centered around patients and community need. Tenet and our predecessors have enabled us to touch many different elements of healthcare and make a difference in the lives of others.Our Impact TodayToday, we are leading health system and services platform that continues to evolve in lockstep with community need. Tenet's operations include three businesses - our hospitals and physicians, USPI and Conifer Health Solutions.Our impact spreads far and deep with 65 hospitals and approximately 510 outpatient centers and additional sites of care. We are differentiated by our top notch medical specialists and service lines that are tailored within each community we serve. The work Conifer is doing will help provide the foundation for better health for clients across the country, through the delivery of healthcare-focused revenue cycle management and value-based care solutions.Together as an enterprise, we work to save lives and can accept nothing less than excellence from ourselves in service of our patients and their families, every day.About the Team: Careers at TenetAt Tenet Healthcare, the heart of what we do centers on caring with compassion, which ultimately creates a bond between our caregivers and patients. Everyone contributes to these moments, whether providing care directly or supporting those who do.As an organization, we provide employees with resources, tools and support to serve our patients and customers in the best way possible. We also take care of one another, helping team members further develop their career pathways and maximize their potential.
