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Case Manager PRN

Nashville, TN, United States

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TriStar Skyline Medical Center – Nashville, TN


Skyline Medical Center is part of the Tristar family of hospitals: TriStar Skyline Medical Center is Tennessee's first comprehensive stroke center and a national leader in neuroscience. The facility is equipped with 233 beds and offers a full array of acute care services, including cardiology, oncology, orthopedics/spine, rehabilitation and emergency services. As an Accredited Chest Pain Center with PCI, TriStar Skyline is a leading provider of emergency heart care. There are more than 400 physicians on staff, many of whom have offices located right next door in the TriStar Skyline Medical Plaza.

Skyline Medical Center provides support for Serious Emergencies, with traumatic injury, saving time is crucial. Tristar Skyline is designated to quickly care for severely injured patients and increase chances of survival. Access to emergency treatment across Middle Tennessee and the greater Nashville area. We're located off of I-65, I-24 and Briley Parkway for convenient access. With two helipads located directly outside of the ER to provide rapid response time Trauma rooms located directly inside ambulance entrance Critical care unit, surgical suites and imaging located next to ER for rapid access to diagnosis and treatment.

TriStar Skyline Medical Center is currently looking for a Case Manager.


Shift: PRN


Department: Case Management


Position Responsibilities:

Utilization Review

  • Complete a clinical review on all patients, utilizing InterQual criteria
  • Ensure that Meditech status reflects the physician status order
  • Refer to external PA per policy
  • Obtain Inpatient status order as appropriate
  • Initiate Condition Code 44 as appropriate
  • Issue Hospital Notice of Non-Coverage as necessary
  • Participate with Utilization Review Case Manager in the appeal and denial process
 Care Coordination
  • Conduct initial interview within 24 -72 hours of admission in order to formulate the transition of care plan/discharge plan
  • Collaborates with physicians and the entire healthcare team to assure appropriate coordination and communication of care needs
  • Provide ongoing review and update of care plan every 72 hours
  • Complete all documentation in the EMR
 Discharge Planning
  • Develops discharge plan and coordinates discharge process with patient/family
  • Obtains patient choices for post hospitalization needs
  • Sends referrals to post acute care providers
  • Documents discharge plan in EMR
               Other duties as assigned




  • Current Tennessee RN licensure
  • BLS
  • 3 years of related clinical experience
  • Demonstrated skill in problem solving, critical thinking, and negotiation.
  • Working knowledge of reimbursement issues (managed care, utilization review, etc.) preferred

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TriStar Skyline Medical Center
Facility: TriStar Skyline Medical Center
Job ID: 06020-69823
Category: Case Management
Contract: PRN/Per Diem
Shift: PRN
Job Class: PRN

Apply Now
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