Case Management RN

Description Introduction

Are you looking for a place to deliver excellent care patients deserve? At TriStar Southern Hills Medical Center we support our colleagues in their positions. Join our Team as a(an) Case Management RN and access programs to assist with every stage of your career.

TriStar Southern Hills Medical Center, offers a total rewards package that supports the health, life, career and retirement of our colleagues. The available plans and programs include:

• Comprehensive medical coverage that covers many common services at no cost or for a low copay. Plans include prescription drug and behavioral health coverage as well as free telemedicine services and free AirMed medical transportation.
• Additional options for dental and vision benefits, life and disability coverage, flexible spending accounts, supplemental health protection plans (accident, critical illness, hospital indemnity), auto and home insurance, identity theft protection, legal counseling, long-term care coverage, moving assistance, pet insurance and more.
• Free counseling services and resources for emotional, physical and financial wellbeing
  
• 401(k) Plan with a 100% match on 3% to 9% of pay (based on years of service)
  
• Employee Stock Purchase Plan with 10% off HCA Healthcare stock
  
• Family support through fertility and family building benefits with Progyny and adoption assistance.
  
• Referral services for child, elder and pet care, home and auto repair, event planning and more
  
• Consumer discounts through Abenity and Consumer Discounts
  
• Retirement readiness, rollover assistance services and preferred banking partnerships
  
• Education assistance (tuition, student loan, certification support, dependent scholarships)
  
• Colleague recognition program
  
• Time Away From Work Program (paid time off, paid family leave, long- and short-term disability coverage and leaves of absence)
  
• Employee Health Assistance Fund that offers free employee-only coverage to full-time and part-time colleagues based on income.

Note: Eligibility for benefits may vary by location.

Are you a continuous learner? With more than 94,000 nurses throughout HCA Healthcare, we are one of the largest employers of nurses in the United States. Education is key to excellence As a majority owner of Galen College of Nursing, which joins Research College of Nursing and Mercy School of Nursing as educational facilities within the HCA Healthcare family, we make it easier and more affordable to gain certifications and job skills. Apply today for our Case Management RN opening and continue to learn

POSITION SUMMARY: 

The Case Manager will facilitate the interdisciplinary plan of care with a focus on evaluating the appropriateness of clinical care, medical necessity, admission status, level of care, and resource management. The Case Manager will coordinate activities that promote quality outcomes and patient throughput while supporting a balance of optimal care and appropriate resource utilization. The Case Manager will identify potential barriers to patient throughput and quality outcomes. The Case Manager will facilitate appropriate discharge plans. 

POSITION QUALIFICATIONS: 

• RN with current state licensure, BSN preferred 

• Three years nursing experience in acute care setting, Case Management experience preferred 

• Certification in Case Management, Nursing, or Utilization Review, preferred 

• Ability to establish and maintain collaborative and effective working relationships 

• Ability to communicate effectively in oral, written and electronic formats 

• Demonstrates analytical and critical thinking abilities with pro-active decision-making and negotiation skills 

• Demonstrates an ability to perform specific competencies as identified on the Case Management Competency Grid 

• Completes and Achieves a minimum score of 88% on the Healthsream Interqual 

PERFORMANCE EXPECTATIONS: 

• Performs a comprehensive assessment of psychosocial and medical needs of assigned patients 

• Develops a case management plan of care to include identified clinical, psychosocial and discharge needs; coordinates plan of care; plan is documented in the medical record; plan is communicated to appropriate clinical disciplines 

• Assumes a leadership role with the interdisciplinary team to manage care, through criteria driven processes, for the appropriate level of care, patient status and resource utilization 

• Conducts interdisciplinary team meetings to provide a mechanism for all clinical disciplines to collaborate, plan, implement, and assess the plan of car; patient selection should be criteria based and interventions will be documented

• Evaluates admissions for medical necessity using approved criteria at defined intervals throughout the episode of care; escalates medical necessity and admission status issues through the established chain of command 

• Validates observation hours and communicates with Revenue Integrity on billable hours 

• Evaluates and assess observation patients for appropriateness in observation status 

• Acts as a liaison through effective and professional communications between and with physicians, patient / family, hospital staff, and outside agencies 

• Demonstrates knowledge of regulatory requirements, HCA Ethics and Compliance policies, and quality initiatives; monitors self-compliance and implements process changes to ensure compliance to such regulations and quality initiatives as it relates to the provision of Case Management Services 

• Makes appropriate referrals to third party payer disease and case management programs for recurring patients and patients with chronic disease states

• Documents professional recommendations, care coordination interventions, and case management activities to effectively communicate to all members of the health care team 

• Facilitates patient throughput with an ongoing focus on quality and efficiency 

• Tracks and trends barriers to care; makes recommendations and develops action plans to improve processes and systems 

• Involves patient, family/responsible/significant others in identifying and clarifying needs and expectations to develop mutual and realistic goals 

• Assesses patients’ post discharge needs and facilitates the provision of services necessary to meet identified needs 

Serving our community for the past 40 years, TriStar Southern Hills has been a leader for a wide range of healthcare services. These include emergency services, cardiology, orthopedics and rehabilitation. TriStar Southern Hills is an Accredited Chest Pain Center with PCI and a Primary Stroke Center. There are more than 300 board certified physicians representing more than 20 specialties. Many have offices located on our campus.

HCA Healthcare has been named one of the World’s Most Ethical Companies by Ethisphere Institute for ten consecutive years (2010-2019). In 2019, HCA Healthcare spent an estimated $3.7 billion in cost for the delivery of charitable care, uninsured discounts, and other uncompensated expenses.

If growth and continued learning is important to you, we encourage you to apply for our Case Management RN opening. Our team will promptly review your application. Highly qualified candidates will be contacted for interviews. Unlock the possibilities apply today

We are an equal opportunity employer and value diversity at our company. We do not discriminate on the basis of race, religion, color, national origin, gender, sexual orientation, age, marital status, veteran status, or disability status.