Case Manager-RN Job

Full Job Title: Case Manager RN

Job Number: 17011475

Facility: SSM Health St. Mary's Hospital - St. Louis

Location: St. Louis, MO

Schedule: Full Time, Weekends

Hours: S/S 8 am to 5:30 PM

Description

Role Purpose:
Evaluates insurance coverage while managing the utilization review process from admission to discharge. Completes and updates medical records pertaining to case management and authorizations. This position
participates in a multidisciplinary palliative care team.
Responsibilities:
    • Joins with treatment team in reviewing comprehensive patient/ family treatment plan.
    • Collaborates with physicians and other health care professional regarding patient plan of care and intermediate care goals within proposed time line.
    • Reviews and evaluates discharge planning on all clients while scheduling follow-up appointments.
    • Evaluates insurance coverage for optimal use of benefits while managing the utilization process from admission to discharge.
    • Interviews patient / family members, obtain a complete initial social history including financial information, and communicate with external case managers to receive authorization of payment.
    • Performs all other duties according to entity policies/procedures as assigned.

Qualifications

Minimum Qualifications:
  • Associate Degree or Diploma School Program
  • Required -State of Missouri Nursing License; Preferred – BSN and UR, QA, or CM certification
  • 1 to 3 years of experience

The 525-bed SSM Health St. Mary's Hospital - St. Louis is a major teaching hospital affiliated with the Saint Louis University Department of Obstetrics and Gynecology. St. Mary's Hospital - St. Louis offers a wide variety of outpatient services, including cardiovascular and open-heart surgery, high-risk obstetrics and comprehensive women's breast health services. The hospital was recognized with the 2008 and 2010 Premier Award for Quality.

SSM Health is an Equal Opportunity and Affirmative Action Employer. Qualified applicants are considered for employment without regard to race, color, religion, sex, national origin, age, disability, veteran status, sexual orientation, gender identity, or any other characteristic protected by law. Learn More »


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