Qualifications
MINIMUM EDUCATION: Bachelor’s Degree from an accredited school, college or university as a Registered Nurse
PREFERRED EDUCATION: Master’s Degree from an accredited college or university in Nursing or related field
MINIMUM EXPERIENCE: 2 years in acute hospital case management, healthcare or leadership experiences
PREFERRED EXPERIENCE: 5 years in acute hospital case management. McKesson InterQual® experience and
Business Planning experience
REQUIRED CERTIFICATIONS/LICENSURE: Possession of current Texas State registration as a Registered
Nurse
PREFERRED CERTIFICATIONS/LICENSURE: Accredited Case Management (ACM)
REQUIRED COURSES/ COMPLETIONS (e.g., CPR): NA
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Tenet complies with federal, state, and/or local laws regarding mandatory vaccination of its workforce. If you are offered this position and must be vaccinated under any applicable law, you will be required to show proof of full vaccination or obtain an approval of a religious or medical exemption prior to your start date. If you receive an exemption from the vaccination requirement, you will be required to submit to regular testing in accordance with the law.
Description
POSITION SUMMARY
Responsible for hospital utilization performance improvement and operational management of the Case Management Department in
order to promote effective utilization of hospital resources, ensure processes support appropriate reimbursement for services rendered,
support efficient patient throughput, and ensure compliance with all state and federal regulations related to case management services.
This position integrates national standards for case management scope of services including: Utilization Management supporting
medical necessity and denial prevention; Transition Management promoting appropriate length of stay, readmission prevention and
patient satisfaction; Care Coordination by demonstrating throughput efficiency while assuring care is the right sequence and at
appropriate level of care; Compliance with state and federal regulatory requirements, TJC accreditation standards and Tenet policy;
Education provided to physicians, patient, families and caregivers. Completes established competencies for the position within
designated introductory period. Other related duties as assigned.