Senior Nurse Case Manager

4 weeks ago

San Antonio, Texas, United States Mission Trail Baptist Hospital Full time

Position Overview

The Lead Registered Nurse in Case Management is tasked with orchestrating patient care throughout the healthcare continuum. This role emphasizes effective resource coordination to empower patients in achieving their optimal health while ensuring appropriate access to care and resource utilization, all while respecting the patient's autonomy and self-determination.

Key Responsibilities

  • Oversee the delivery of care at the appropriate medical necessity level.
  • Assess patient transition needs to facilitate timely throughput and safe discharges, while actively working to prevent avoidable readmissions.
  • Incorporate national standards for care management, including:
    • Utilization Management to support medical necessity and prevent denials.
    • Transition Management aimed at promoting suitable lengths of stay, readmission prevention, and enhancing patient satisfaction.
    • Ensure compliance with state and federal regulations, TJC accreditation standards, and internal policies.
    • Provide educational resources to physicians, patients, families, and caregivers.
    • Conduct educational programs for the Case Management Department focusing on community resources for discharge planning.
    • Generate reports for the Director of Case Management and hospital leadership as needed.
    • Lead the discharge planning unit, offering guidance and oversight.

Qualifications

Minimum Education: Graduate from an accredited School of Nursing.
Preferred Education: Bachelor’s or Master’s Degree in Nursing.

Minimum Experience: At least 2 years of acute hospital patient care experience, with a background in utilization or case management. A minimum of 1 year in a supervisory role is required. Proficiency in relevant computer programs is essential.
Preferred Experience: Previous supervisory experience in Case Management.

Licensure and Certifications:

Required: Current Texas State license for Registered Nurse or LMSW/LCSW.
Preferred: Certification in Case Management (CCM, ACM).

Required Training: BLS certification obtained through an approved American Heart Association Training Center or Military Training Network.

Compliance Statement: Mission Trail Baptist Hospital adheres to all federal, state, and local laws regarding mandatory vaccination of its workforce. Candidates may be required to provide proof of vaccination or obtain an exemption prior to employment.

Diversity and Inclusion: Employment practices will not be influenced by an applicant's or employee's race, color, religion, sex, national origin, age, disability, genetic information, sexual orientation, gender identity or expression, veteran status, or any other legally protected status. Reasonable accommodations will be made for qualified individuals with disabilities unless it results in undue hardship.

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