Description
Description SHIFT: No Weekends
SCHEDULE: Full-time
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 our Case 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. We would love to talk to you about this fantastic opportunity. Seeking a Case 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).
Qualifications Education: - Graduate of an accredited Baccalaureate Degree Nursing Program
Experience: - 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 opened in 1963 as the first hospital in the now internationally acclaimed South Texas Medical Center. With over 800 beds, Methodist Hospital offers a broad range of specialties including cardiology, oncology, bone marrow transplants, emergency medicine, neurosciences, maternity care, gynecology and orthopedics. We are proud to be the largest provider of the lifesaving ECMO Program in San Antonio, are home to the largest robotics program in the world, and our Adult Blood Cancer and Stem Cell Transplant unit has become the first program to receive FACT Accreditation in North America. As the flagship hospital, and most comprehensive medical care facility of Methodist Healthcare, we appreciate the support and recognition we receive from the community. We’ve recently been named the No.1 Best Regional Hospital by the U.S. News and World Report for 2019-20. We pride ourselves on providing the highest quality of care possible for our patients, which is proven by our consecutive Grade A Leapfrog Hospital Safety scores. In addition, Methodist Hospital not only received a Primary Stroke Center designation from The Joint Commission, but has also received a Comprehensive Stroke Center Certification from DNV GL Healthcare, designating the facility as offering the most advanced stroke treatment available in a given geographic area. For more information, please visit our website at www.sahealth.com and select Methodist Hospital 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.
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