Top 14 Nurse case manager Jobs in Greenbrier Ar

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nurse case manager jobs near greenbrier ar

Case Manager PRN

Conway Regional Heath System -
Conway, AR

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Job Details

Qualifications

Collaborate with healthcare professionals
Appeals
Nursing
Inpatient experience
RN License
Overseeing healthcare denial management
Filing
Employee relationship building
Research
Mid-level
Transitional care planning in clinical case management
Case appeal in utilization management
Records management
Data management
Utilization management
Medical record retrieval
Resource utilization in healthcare
Concurrent review in utilization management
LPN
1 year
Clinical confidentiality policies
Managing patient records
Clinical data analysis
Managing patients as a clinical case manager
Insurance claims appeal handling
Process management
Nursing

Full Job Description

Overview:

Provides discharge planning and utilization review services in compliance with patients discharge planning needs and the hospital’s utilization review program.

SAFETY SENSITIVE POSITION:

This position is a designated as “Safety Sensitive Position” under Act 593 of the State of Arkansas. An employee who is under the influence of Marijuana constitutes a threat to patients/customers which Conway Regional is responsible for in providing and supporting the delivery health care related services.

Qualifications:

Registered Nurse or Licensed Practical Nurse with current, active license to practice in Arkansas, required
Proof of the highest level of nursing education achieved, required
At least one-year experience in the area of case management/utilization review, preferred

Responsibilities:

Apply clinical knowledge to determine appropriate acuity levels and utilization through chart review.
Effectively organizes workflow to consistently complete assignments in a timely manner.
Demonstrates ability to access and effectively utilize primary sources of data.
Obtains and maintains medical records in conformance with Medical Information policies.
Communicates with co-workers in a manner that is conducive to positive and effective working relationships. Demonstrates respect, honesty and integrity when working with other service providers.
Demonstrates compliance with all relevant hospital, state and federal requirements related to maintenance of confidentiality of persons, data and information systems.
Takes advantage of opportunities made available through CRHS and other professional organizations for continued professional growth and development.
Responsible for analysis of patient information for determination of necessity of admission or continuation of stay.
Review for medical necessity of admission on the first working day after admission using approved review criteria.
Reviews inpatient procedures to determine appropriate utilization and acuity level. Reviews potential for outpatient setting or swing bed utilization.
Reviews all patients for medical necessity of continued stay, or before the next review date, using approved review criteria.
Performs retroactive reviews, as necessary, and responds to the appropriate review agency or third party payor.
Researches denials issued by review agencies and third party payors and responds within the specified time frames for appeal.
Works with others on healthcare team to coordinate for patients discharge needs.
Establishes an effective utilization review process and maintains an active, effective utilization review file system. Recommends, develops and revises policies related to the utilization review process.
Works collaboratively with physicians, Case Management, the discharge planning process, Admissions, Central Scheduling and other CRHS associates.
Educates staff, physicians and other personnel regarding medical necessity requirements as defined by approved review criteria.
Assists with other department functions as assigned.

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nurse case manager jobs in greenbrier ar

Case Manager PRN

HOME HEALTH CASE MANAGER RN

RN Admissions Behavioral Health

Travel ICU RN Job in Tuscaloosa, Alabama

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