staff - Registered Nurse (RN) - Case Management - $31-...

Baptist Health System - San Antonio TX is seeking a Registered Nurse (RN) Case Management for a nursing job in San Antonio, Texas. Job Description & Requirements Specialty: Case Management Discipline: RN Duration: Ongoing 36 hours per week Shift: 12 hours Employment Type: Staff POSITION SUMMARY The individual in this position works under the direction of the RN and/or Social Worker to complete referrals for post-acute services for patients, and assists with tasks that do not require a clinical license or degree. The individual's responsibilities include the following activities: a) arrange post-discharge services; b) create and follow up on electronic referrals using the Tenet Case Management system; c) review patient choice letters with patients/families for required signatures; d) provide follow up Important Message to Medicare patients prior to discharge; e) communicate with patients, families and other members of the care team; f) complete tasks assigned by Case Manager and Social Work staff; g) make copies, send faxes and complete phone calls; h) complete process reviews or audits as requested; and i) other duties as assigned. General Functions: Utilization Management ? Validates patient's demographic and payer information with patient/family and notifies Patient Access immediately if any corrections are needed within 24 hours of admission ? Validates that all commercial/managed care discharge have an authorization for status and level of care provided and notifies Director of Case Management (DCM) or designee of variances ? Escalates discharged cases at end of the day that have no authorization or notification or dispute is provided by payor. ? Ensures, on a concurrent basis, that all clinical needed by payors and updates are provided by 100% alerting Case Manager assigned to case and escalating to DCM if not complete timely ? Trends dispute/denial potential to DCM or designee by failure points to revenue cycle ? Prepares denial information for UR Committee, Denial and Revenue Cycle Meetings ? Collaborates with Patient Access, Case Management, Managed Care and Business office to improve concurrent review process to avoid denial or process delays in billing accounts. Transition Management ? Follows up on Authorization for post-acute services ? Makes referrals for post-acute services under the direction of the RN Case Manager or Social (SW) staff utilizing the Tenet Case Management documentation system.. ? Follows-up if referral requires authorization by payor to discharge the patient ? Completes tasks as assigned by RN or LVN Case Manager and/or SW staff ? Makes copies, sends faxes and complete phone calls to arrange post-acute services and to ensure that appropriate hospital information is communicated to post-acute serviced and to ensure that appropriate hospital information is communicated to post- acute providers ? Documents all referrals and tasks in the Tenet Case Management documentation system per Tenet policy ? Provides Important Message follow-up letters to Medicare beneficiaries per Tenet policy and under the direction of the RN Case Manager or SW Compliance ? Adheres to federal, state, and local regulations and accreditation requirements impacting case management scope of services ? Adheres to department structure and staffing ,policies and procedures to comply with the CMS Conditions of Participation and BHS/Tenet policies Other: ? Utilizes resources efficiently and effectively ? Maintains safe environment ? Participates in Performance Improvement activities MINIMUM EDUCATION: High School diploma or equivalent PREFERRED EDUCATION: Associate's or Bachelor's Degree from an accredited college MINIMUM EXPERIENCE: 2 years of experience in clerical or healthcare field. Possesses excellent organizational, verbal/ written communication skills, problems solving and computer literacy skills. Data Analytics skills. PREFERRED EXPERIENCE: Acute hospital experience REQUIRED CERTIFICATIONS/LICENSURE: NA PREFERRED CERTIFICATIONS/LICENSURE: Paramedic, EMT or Nursing Assistant certifications. REQUIRED COURSES/ COMPLETIONS (e.g., CPR): NA #LI-NS1 Baptist Health System - San Antonio Job ID #2503035071. Posted job title: Discharge Planner - Case Mgmt Benefits Health Care FSA Dependent Care FSA Life insurance Compensation Information: $31.00 / hourly - $44.00 / hourly

Created: 2026-03-08