RN Case Manager in Vidalia, Georgia, United States
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Memorial Health Meadows Hospital

RN Case Manager

Vidalia, GA, United States
Full-time • Days 7-10 Hrs/Wkends Rotate
Case Management   Job ID: 287025
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Description

Introduction

Do you want to be appreciated daily? Our nurses are celebrated for being on the front line, empathetic for patients. At Memorial Health Meadows Hospital our nurses set us apart from any other healthcare provider. We are seeking a RN Case Manager to join our healthcare family.

Benefits

*$10,000 Sign On Bonus for eligible candidates!

Memorial Health Meadows Hospital, offers a total rewards package that supports the health, life, career and retirement of our colleagues. The available plans and programs include:

  • Comprehensive medical coverage that covers many common services at no cost or for a low copay. Plans include prescription drug and behavioral health coverage as well as telemedicine services and free AirMed medical transportation.
  • Additional options for dental and vision benefits, life and disability coverage, flexible spending accounts, supplemental health protection plans (accident, critical illness, hospital indemnity), auto and home insurance, identity theft protection, legal counseling, long-term care coverage, moving assistance, pet insurance and more.
  • Fertility and family building benefits through Progyny
  • Free counseling services and resources for emotional, physical and financial wellbeing
  • Family support, including adoption assistance, child and elder care resources and consumer discounts
  • 401(k) Plan with a 100% match on 3% to 9% of pay (based on years of service)
  • Employee Stock Purchase Plan
  • Retirement readiness and rollover services and preferred banking partnerships
  • Education assistance (tuition, student loan, certification support, dependent scholarships)
  • Colleague recognition program
  • Time Away From Work Program (paid time off, paid family leave, long- and short-term disability coverage and leaves of absence)

Learn more about Employee Benefits

Note: Eligibility for benefits may vary by location.

At Memorial Health Meadows Hospital, our nurses play a vital part. We know that every nurse’s path and purpose is unique. Do you want to create your own personal career path in nursing? HCA Healthcare is your career destination! Our scale makes it possible for nurses to create the career path that fits their life – for life – and empowers their passion for patient care. Apply today for our RN Case Manager opportunity.

Job Summary and Qualifications

The purpose of the RN Case Manager is to work within a defined patient population to promote the achievement of optimal clinical and resource outcomes. Responsible for facilitating appropriate lengths of stay and reimbursement for all hospital admissions, observation admissions in accordance with goals and objectives. Acts as resource for the interdisciplinary team. Works to develop organization wide approaches to problem solving. Analyzes current systems and variances to identify opportunities for improvement. Works to promote quality of care through collaboration with all service team members, patients and families. Continual focus on services improvement is also integral.


What you will do in this role:

  • Assists patients, physicians & co-workers while providing customer service techniques to ensure the patient experience is excellent. 
  • Facilitates the collaborative management of patient care across the continuum, intervening when necessary to remove barrier to timely and efficient care delivery and reimbursement. 
  • Performs precertification and payer authorization processes, as required. 
  • Conducts initial and continued stay reviews of all inpatients observation to ensure appropriate medical necessity met, level of care, resource 
  • Reviews Medicare inpatients to identify principal diagnosis and procedures, secondary diagnosis and procedures to assign DRG. 
  • Reviews Medicare inpatients to identify comorbid conditions, complications and updates DRG on worksheet and collaborate with MD. 
  • Reviews the necessity of continued stay by utilization Interqual criteria. 
  • Uses approved UM methods for accurate documentation in the medical record after each review. 
  • Reviews and communicates with MD discharge planner, nurse and discharge needs to facilitate and ensure continuity, timeliness. 
  • Apply interqual/milliman criteria to ensure medical necessity for admission criteria is met or observation services. 
  • Refers cases to secondary level review physicians, per policy. 
  • Uses approved UM methods for accurate documentation in the medical record after each review. 
  • Ensures physician query process is in compliance with the American Health Information Association clinical query guidelines. 
  • Assist with providing education for the department and participates personally in continuing education. 
  • Responsible for Third party policies being met for notification and precertification 
  • Refers cases to Physician Advisors that fail approved clinical criteria for inpatient or observation. 
  • Communicates with members of the medical staff, department and other health care providers on an ongoing basis to validate the documentation in the medical record adequately reflects the diagnosis being treated and the procedures performed

What qualifications you will need:
  • Must be a graduate from an accredited school of Nursing: Associate's Degree in Nursing or higher is required
  • Must be licensed as a Registered Nurse in the state which you practice and/or hold an active Compact/Multi-State RN license
  • Basic Life Support (BLS)


Memorial Health Meadows Hospital is a regional health system featuring a state-of-the-art hospital, cancer center and a network of physician practices that serve Vidalia, Ga. and the surrounding communities. Meadows Health includes the only nationally accredited hospital in Montgomery, Toombs, Treutlen and Tattnall counties. The center offers the latest in medical advancements including cutting-edge cancer care, life-saving heart attack procedures, women’s services, wound care, orthopedic medicine and more.

This role requires you to be fully vaccinated for COVID-19 based on local, state and /or federal law or regulations (unless a medical or religious exemption is approved).

 

"The great hospitals will always put the patient and the patient's family first, and the really great institutions will provide care with warmth, compassion, and dignity for the individual."- Dr. Thomas Frist, Sr.
HCA Healthcare Co-Founder

Join a family that cares about every stage in your career! We are interviewing candidates for our RN Case Manager opening. Apply today and a member of our Talent Acquisition team will reach out.

We are an equal opportunity employer and value diversity at our company. We do not discriminate on the basis of race, religion, color, national origin, gender, sexual orientation, age, marital status, veteran status, or disability status.

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Details

Case Management
Full-time • Days 7-10 Hrs/Wkends Rotate

COVID-19 Vaccination

In compliance with the emergency regulation issued by the Centers for Medicare & Medicaid Services (CMS) dated November 4, 2021, and company policy, this role requires you to be fully vaccinated for COVID-19 based on local, state and /or federal law or regulations, or to have applied for a medical or religious exemption (including booster for California).

About HCA Healthcare

What matters most to our diverse and talented colleagues is giving people the absolute best healthcare in the most compassionate way possible.

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