Location:

Department:

Shift:

Standard Weekly Hours:

Summary:

The ED RN Case Manager will work with a defined patient population to facilitate the correct status designation of place into observation (OBS) or admit into inpatient. This position will promote optimal clinical outcomes and resource utilization to insure that all patients are placed in the correct bed status, using approved clinical criteria Indicia (MCG) and InterQual Clinical Criteria. This position will work in collaboration with the ED physicians as well as Patient Access staff to correctly enter the patients status for accurate billing and required payor authorization/notification.

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Schedule: Weekends 2-10 hours shifts 7:30 am-5:30 pm

Education and Experience

• Associate degree in nursing.
• At least three years of any combination of experiences working in/with case management, care coordination, utilization review, patient intake, discharge planning and troubleshooting fund resources, quality assurance, clinical pathways, continuous quality improvement, or state and federal health plans or commercial insurance plans in a clinical or managed care environment.
• Must be computer literate, and have effective organizational, interpersonal, written, and oral communication skills.
• Must be familiar with various community resources and charitable organizations.
• Must be able to adapt to changing healthcare environments and work with all members of the healthcare team to achieve positive outcomes.
• Must have experience using or navigating electronic medical records (e.g., EPIC, Meditech, Healthy Planet, etc.).
• BSN from an accredited college or university is preferred.
• Bilingualism is preferred or may be required depending on the specific department assignment.

Licensure, Registration, and/or Certification

• Current RN license from Texas Board of Nursing required.
• Must achieve a Basic Life Support (BLS) certification for Health Care Providers within 30 days of employment and must maintain this certification.

*This requirement does not apply to Health Plan

• Case Manager Certification (CCM) preferred.

About Us:

Cook Children’s is an equal opportunity employer. As such, Cook Children’s offers equal employment opportunities without regard to race, color, religion, sex, age, national origin, physical or mental disability, pregnancy, protected veteran status, genetic information, or any other protected class in accordance with applicable federal laws. These opportunities include terms, conditions and privileges of employment, including but not limited to hiring, job placement, training, compensation, discipline, advancement and termination.

Cook Children’s is a Texas-only employer. If you are hired, you will need to maintain your primary residence within the state of Texas, along with all licenses and credentials required for your position throughout your employment.