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Description
Do you have a passion for healthcare and helping others? Do you enjoy working in a fast-paced, patient-centered environment? Jump-start your career in ourCase Management department. Submit your application today!
Benefits:We offer you an excellent total compensation package, including competitive salary, excellent benefit package and growth opportunities. We believe in our team and your ability to do excellent work with us. Your benefits include 401k, PTO medical, dental, flex spending, life, disability, tuition reimbursement, employee discount program, employee stock purchase program and student loan repayment. We would love to talk to you about this fantastic opportunity.
Seeking aCase Manager Coordinator to join our team who will be responsible for facilitating effective & appropriate health services throughout the continuum of care. Collaborative and systematic processes are used to assess patient needs, plan services and collect data. Additionally, this position assists in the coordination, implementation, monitoring and evaluation of options and services to meet the individual’s healthcare needs. Communication with physicians, payers and others to promote fiscal responsibility and effective use of available resources to decrease fragmentation of care across all settings.
What you will do in this role:
- Assess by interview and chart review discharge needs of all high risk patients and other referred patients. Identify resources available to address needs, offer and document choices, coordinate referrals and document plan to include the final discharge disposition.
- Perform admission and continued stay reviews as per CM plan. Provide clinical information to payers for certification and reimbursement of care. Discuss alternate level of care with physicians. Refer cases not meeting acute criteria to Physician Advisor, as needed.
- Facilitates and/or provides education of hospital staff, physicians, patients and caregivers for purposes of efficient resource utilization. Acts as a resource for staff and other departments.
- Keeps current on JC standards, CMS (Conditions of Participation, Core Measure, etc.). Review criteria and other rules that govern the provision of care, planning and documenting.
- Tracks resource or other information used to identify improvement opportunities. Attends medical staff, hospital committee meetings and/or discusses findings with appropriate staff.
- Conducts special projects to reduce patient’s length of stay such as tracking avoidable days in relationship to high risk DRGs (Heart Failure, COPD and Sepsis).
Education:
- Graduate of an accredited Baccalaureate Degree Nursing Program
- 5 years RN experience in acute care case management, including knowledge of: Diagnosis Related Group (DRGs) and ability to assess clinical data to determine a working DRG; appropriate intervention strategies to reduce length of stay and manage utilization; and reimbursement mechanisms and managed care issues that impact medical necessity and discharge planning.
License and Certification:
- Current Texas licensure as a Registered
Be a part of an organization that invests in you. We are actively reviewing applications. Qualified candidates will be promptly contacted by our hiring managers for interviews. Submit your application today and help us raise the bar in patient care!
Methodist Hospital Stone Oak continues to grow and build on our reputation as a hospital where high-tech and high-touch come together. It is a streamlined, energy-efficient, patient-focused health care facility equipped with the most modern technology available. With over 240 beds, services include emergency care, general surgery, obstetrics and gynecology, neonatology, oncology, neurosurgery, orthopedics, and acute rehab services.
Methodist Hospital Stone Oak is accredited by the Joint Commission as a Primary Stroke Center and Chest Pain Center. The stroke rehabilitation program has received the Joint Commission's Gold Seal of Approval® for Disease-Specific Care Certification of Stroke Rehabilitation. Methodist Hospital Stone Oak belongs to the Texas Institute for Robotic Surgery and has become a leader in robotic surgeries with a highly experienced team of surgeons offering this minimally invasive option to patients. Surgeons from around the country come to train under the facility’s world class team. The hospital has been nationally recognized by Leapfrog’s Hospital Safety Grade A and by Modern Healthcare as one of the Top 100 Best Places to Work in Healthcare. It also been recognized as a Joint Commission Top Performer on Key Quality Measures® and by Medicare.gov as #1 in San Antonio and #6 in the entire nation. Methodist Hospital Stone Oak is 1 of only 102 hospitals to receive Medicare.gov’s 5-star rating. For more information, please visit our website at www.sahealth.com and select Methodist Hospital Stone Oak under Locations.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.Vacancy expired!