A bit about us:
One of the TOP hospitals in South Florida as rated by U.S. News & World Reports is looking to hire a talented RN Case Manager for the growing division! Our Hospital has a supportive leadership team that offers all our employees extensive training programs, millions of dollars in tuition assistance and a generous, comprehensive benefits package!
Why join us?
- Medical, Dental and Vision Coverage
- 403B Retirement plan with match
- Trustmark Universal Life with Long Term Care Benefits
- Trustmark Cri1cal Illness
- Trustmark Accident Plan
- Trustmark Short Term Disability
- Colonial Cancer Plan
- Pet Insurance – Pet Assure
- Preferred Legal Plan
- ProtectMyID
- Short term Disability Coverage
- Generous Paid time off
Job Details
- The RN Case Manager will conduct initial, concurrent, retrospective chart review for clinical financial resource utilization.
- Coordinates with healthcare team for optimal/efficient patient outcomes, while decreasing length of stay (LOS) and avoid delays and denied days. The RN Case Manager will be accountable for a designated patient caseload and provides intervention, coordination to decrease avoidable delays, denial of reimbursement.
- The RN Case Manager will screen pre-admission, admission process using established criteria for all points of entry.
- Knowledge of INTERQUAL Criteria is preferred
- Facilitates communication between payers, review agencies, healthcare team. Identify delays in treatment or inappropriate utilization and serves as a resource.
- Coordinates communication with physicians. Identify opportunities for expedited appeals and collaborates resolve payer issues.
- Ensures/Maintains effective communication with Revenue Cycle Departments.
- RN Must have Associates Degree in Nursing and MUST complete their BSN Degree within 5 years of date of hire