RN / Case Management Job in San Antonio, Texas / Hospital
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Description
Standard Qualifications: Methodist Texsan Hospital excels in nearly all aspects of advanced cardiovascular services and is equipped with dedicated operating room suites and five functional heart catheterization labs. Orthopedic services, which include the famed Joint Replacement Academy, boast some of the best clinical results in the industry. Methodist Texsan Hospital's 30-bed inpatient rehabilitation unit is the newest in the community and takes a team approach to providing excellent rehabilitative care for its patients. The emergency room is full-service and its board-certified emergency medicine doctors work hard for the right clinical diagnosis who strive to take care of patients quickly and efficiently. Methodist Texsan Hospital is licensed for 120 beds and has been nationally recognized by Leapfrog's Hospital Safety Grade A. It is the first hospital in San Antonio to receive the Joint Commission's Gold Seal of Approval® for Chest Pain Certification . The hospital has also been recognized among Modern Healthcare Magazine's Best Places to Work in Healthcare. For more information, please visit our website at xxxxxxxxxxx* and select Methodist Texsan Hospital under Locations. General Statement of Duties: The Case Manager will work with patient/families identified to have discharge planning, psychosocial, financial or other needs to develop a plan that will: 1) Optimize functional and self-care abilities; 2) facilitate system access and appropriate utilization of services; 3) facilitate communication and coordination of efforts among health care team members; and 4) promote quality, cost effective outcomes. The Case Manager will demonstrate knowledge and skills necessary to develop a plan based on physical, psychosocial, educational and age related criteria Essential Job Functions: 1. Assesses by interview and charts review discharge needs of all high-risk patients (and others referred). Identifies resources available to address the needs identified, coordinate referrals and document plan. 2. Utilize community resources to support patient's post hospital needs. Documents choice in available resources has been offered. 3. Performs admission and continued stay reviews. Provides clinical information to payers upon request for certification and reimbursement of care. Discusses alternate level of care with physician. Refers cases not meeting acute care criteria to Physician Advisor as needed. 4. Facilitates and or provides education of hospital staff, physicians, patients and caregivers for purposes of efficient resource utilization 5. Keeps current of requirements by JCAHO, HCFA and other state/federal agencies on provision of care, planning and documenting. 6. Tracks resource statistics to identify improvement opportunities. Attends medical staff and other hospital committee meetings to report findings.
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