RN Case Manager/Utilization Review

PRN; WEEKENDSHistory: Martin County Hospital District (MCHD) was organized in 1967 and has boundaries coterminous with Martin County, Texas. It is located in the heart of West Texas. Opened in 1949, the hospital was originally located near downtown Stanton. This facility served the community well for many years, but was replaced with a state of the art 18 bed facility in 2012. The new facility is located on I20, and has been designated as a Critical Access Hospital. SUMMARY OF RESPONSIBILITIES: Case Manager is responsible for evaluating the appropriateness, medical necessity and efficiency of healthcare services. Review of medical records to determine if the services provided meet the criteria for admission. Ensure that patients are receiving the appropriate level of care based on clinical guidelines and best practices. Performs pre-authorization and ongoing review for medical treatments and services needed. Collaborates with healthcare providers to ensure that the care delivered aligns with the coverage guidelines. Will coordinate with healthcare providers, patients, and families to ensure smooth transition of care. Will Monitor the appropriateness of hospital admission, extended stays and discharges from the hospital.RequirementsEDUCATION: Graduate of an accredited school of Professional Nursing.LICENSE/CERTIFICATES: Registered Nurse by the State of Texas. Current BLS required. EXPERIENCE: Effective oral and written communication abilities.Educating skills within scope of practice.Three years prior in nursing or social worker experience is required. Mission Statement Committed to excellence, Martin County Hospital District will provide the highest quality, compassionate care to improve the lives of those we serve. Vision Statement Martin County Hospital District strives to ensure the availability and viability of patient-centered primary and specialty care in a rural setting.Martin County Hospital District is an equal opportunity employer that is committed to diversity, strong morals, values, and ethics. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, or other characteristic protected by applicable law.