RN Case Manager
Nursing | Memphis, TN | Contract
RN Case Manager - Memphis
InGenesis Solutions is seeking for a RN Case Manager to work for our client located in Memphis, TN. As a Nurse Case Manager, you will be accountable for promoting interdependent collaboration with the member, physician/primary care manager, family and other members of the health care or case management team. To accomplish this collaboration, the case manager will assess, implement, monitor, and evaluate available resources in an effort to promote quality, cost effective outcomes while meeting the individual’s health needs. The case manager identifies appropriate providers and facilities in an effort to improve or maintain the social, emotional, functional and physical health status of the client, as well as enhance the coping skills of the family or other caregiver.
Case Management Functions
• Conduct a thorough and objective evaluation of the client’s current status including physical, psychosocial, environmental, financial, and health status expectation.
• As a client advocate, seek authorization for case management from the recipient of services (or designee).
• Assess resource utilization and cost management; the diagnosis, past and present treatment; prognosis, goals (short- and long-term).
• Identify opportunities for intervention.
• Set goals and time frames for goals appropriate to individual.
• Arrange, negotiate fees for, and monitor appropriate cases and services for the client.
• Maintain communication and collaborate with patient, family, physicians and health team members, and payer representatives.
• Compare the client’s disease course to established pathways to determine variances and then intervene as indicated.
Registered Nurse with active license in the state of Tennessee or hold a license in the state of their residence if the state is participating in the Nurse Licensure Compact Law.
Minimum of five (5) years health care experience with at least three (3) years of clinical experience,
Prefer two (2) years experience in Utilization Management, Case Management or Managed Care.