Registered Nurse (RN) Case Manager

This is for a Denials CM, denials experience required.


Tomball Regional Medical Center - Tomball, Texas


Registered Nurse (RN) Case Manager - Utilization Review
Since 1976, Tomball Regional Medical Center (TRMC) has provided quality healthcare to the communities we serve including emergency care, labor and delivery, a level III Neonatal Intensive Care Unit (NICU), general surgery, cardiology, pulmonary medicine, acute inpatient rehabilitation, sports medicine, physical therapy, orthopedics, outpatient testing, wound care and many others. Our 150-acre campus and 350 bed hospital also features designated specialty centers: the Heart Center, the Tomball Regional Medical Center Wound and Hyperbaric Center, and Texas Sports Medicine Center.


Tomball Regional Medical Center is currently looking for a Registered Nurse (RN) - Utilization Review.

Responsibilities:


  • Actively participates in the collaborative program which requires review of patient activities related to medical necessity of hospitalization, appropriateness of length of stay, timely and appropriate utilization of services rendered, and identification of patient needs related to patient care following discharge.
  • Facilitates discharge planning efforts to promote timely and safe discharge from the hospital. The case manager promotes quality care and cost-effective outcomes to enhance the physical, psychosocial and vocational health of individuals. T
  • he position encompasses assessing, planning, implementing, coordinating and evaluating health-related service options throughout the continuum.



Qualifications:
Qualifications:

Required Education:
  • Graduate of an accredited school of nursing.

Licensure Required:
  • Current or pending licensure in Texas as an RN.

Experience:
  • Five years professional nursing or social work experience desirable.
  • Certification in Case Management desirable.

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