RN Case Manager - Full Time - United Surgical Partners International

Arizona Specialty Hospital is seeking an experienced Registered Nurse Case Manager to join our team! This position is full time.

The RN Case Manager responsibilities include:

• Working independently while handling multiple priorities simultaneously.
• Utilizes the nursing process of assessment, planning, implementation and evaluation to direct or provide nursing care.
• Manages patients across the healthcare continuum to achieve optimal clinical, financial, operational and satisfaction outcomes.
• Assess the patients’ plan of care and develops, implements, monitors and documents the utilization of resources and progress of the patient through their care.
• Active participant in the interdisciplinary healthcare team to promote/facilitate discharge planning, facilitating options and services to meet patients’ health care needs.
• Identifies and intervenes when necessary to ensure efficient and cost-effective delivery of patient care services.
• Coordinates the necessity of case management and utilization review for any patient at AZSH.
• Provides requested documentation to payors in a timely manner.
• Establishes and promotes collaborative relationships with physicians, patients, families and additional members of the healthcare team.
• Educates members of the healthcare team on case management and managed care concepts.
• Review medical necessity and coordinate with the interdisciplinary team to assure correct status for payment.
• Assist with clinical interpretation for denial and appeals management.
• Knowledgeable about Medicare, Medicaid, and commercial insurance plans.
• Strong analytical, organizational, and time management skills.
• Experience with InterQual and or MCG
• EMR Experience

Benefits:

• Medical, Dental, Vision
• PTO and Sick time Plans
• 401k after 30 days
• Employer Paid Life Insurance
• Employee Paid Life Insurance
• and more!

Requirements

• Unencumbered RN license
• Hospital experience preferred

• Current unencumbered RN license
• Recent Case Management experience in a hospital setting
• Utilization review experience
• Discharge planning in a hospital setting
• Ability to be part of the RN Case Management On Call rotation, with 1-2 on call weekends a month, depending on case load.