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RN-Case Manager

Company: Dean Health
Location: Jefferson City
Posted on: June 8, 2021

Job Description:

PRIMARY RESPONSIBILITIES

  • Reviews electronic medical record and screen clinical information with nationally recognized criteria.
  • Discusses with payor regarding criteria and payor decision.

  • Escalates denials to physician (advisor, attending consultant, outside consultant) for peer to peer consideration.

  • Documents outcome in electronic medical record.

  • Active participant with other members of team regarding opportunities for improvement in standard work.

  • As an SSM Health nurse, I will demonstrate the professional nursing standards defined in the professional practice model.

  • Uses the ANA Code of Ethics for Nurses to guide his/her response to the current and evolving health and nursing needs of our patients and our patient populations.

  • Performs other duties as assigned.

EDUCATION

  • Graduate of accredited school of nursing

EXPERIENCE

  • Two years' registered nurse experience
  • Ensure payors receive clinical information to support services provided by hospital. Ensures hospital receives authorization from payor.

Keywords: Dean Health, Jefferson City , RN-Case Manager, Other , Jefferson City, Missouri

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