RN Case Manager I Per Diem Days MTBH
5 months ago
POSITION SUMMARY
Responsible to facilitate care along a continuum through effective resource coordination to help patient achieve optimal health, access to care and appropriate utilization of resources balanced with the patient’s resources and right to self-determination. Has overall responsibility for ensuring that care is provided at the appropriate level of care based on medical necessity and to assess the patient for transition needs to provide timely throughput, safe discharge and prevent avoidable readmissions. Integrates the national standards for care management scope of services including: Utilization Management supporting medical necessity and denial prevention; Transition Management promoting appropriate length of stay, readmission prevention and patient satisfaction; Compliance with state and federal regulatory requirements, TJC accreditation standards and Tenet policy; Education provided to physicians, patients, families and caregivers; Provides education programs for Case Management Department on community resources used in discharge planning; Provides reports to DCM and hospital leadership as requested; Team Leader for discharge planning unit, providing guidance and monitoring.. Completes established competencies for the position within designated introductory period. Other related duties as assigned
POSITION QUALIFICATIONS
MINIMUM EDUCATION: Graduate of an accredited School of Nursing
PREFERRED EDUCATION: Bachelors or Masters Degree in Nursing
MINIMUM EXPERIENCE: 2 years acute hospital patient care experience. Utilization/case management experience. 1 year supervisory experience. Demonstrates computer knowledge of programs related to position and displays competency on an ongoing basis.
PREFERRED EXPERIENCE: Previous Case Management Supervisory experience.
REQUIRED CERTIFICATIONS/LICENSURE: Possession of current Texas State license for Registered Nurse or LMSW/LCSW
PREFERRED CERTIFICATIONS/LICENSURE: Certification in Case Management (CCM, ACM)
REQUIRED COURSES/ COMPLETIONS (., CPR): Must have active healthcare provider Basic Life Support on hire (ARC or AHA); however, must have AHA Healthcare Provider BLS within 60 days of hire
#LI-NS1
Tenet complies with federal, state, and/or local laws regarding mandatory vaccination of its workforce. If you are offered this position and must be vaccinated under any applicable law, you will be required to show proof of full vaccination or obtain an approval of a religious or medical exemption prior to your start date. If you receive an exemption from the vaccination requirement, you will be required to submit to regular testing in accordance w
The individual’s responsibilities include the following activities:
a) accurate medical necessity screening and submission for Physician Advisor review,
b) care coordination,
c) transition planning assessment and reassessment,
d) implementation or oversight of implementation of the transition plan,
e) leading and facilitating multi-disciplinary patient care conferences,
f) managing concurrent disputes,
g) making appropriate referrals to other departments, h ) identifying and referring complex patients to Social Work Services,
I) communicating with patients and families about the plan of care,
j) collaborating with physicians, office staff and ancillary departments,
k) leading and facilitating Complex Case Review,
l) assuring patient education is completed to support post-acute needs ,
m) timely complete and concise documentation in Case Management system,
n) maintenance of accurate patient demographic and insurance information,
o) identification and documentation of potentially avoidable days,
p) identification and reporting over and underutilization,
q) and other duties as assigned.
Required: Graduate of an accredited school of nursing
Preferred: Academic degree in nursing (bachelor's or master's)
Required: 2 years of acute hospital patient care experience
Preferred: Acute hospital case management experience
Required: RN. Must be currently licensed, certified or registered to practice profession as required by law or regulation in state of practice or policy. Active RN license for state(s) covered.
Preferred: Accredited Case Manager (ACM)
Lift/position up to 25 lbs. Push/pull up to 25 lbs. of force. Frequent sitting. Moderate standing, walking, reaching, stooping, and bending. Manual dexterity, mobility, touch, auditory to perform all the related duties of the position.
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