RN / Case Management Job in San Antonio Live Oak, Texas / Hospital
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Description
Standard Qualifications: Northeast Methodist Hospital has played a major role in the phenomenal economic growth experienced in northeast Bexar County. It is licensed for 116 beds and has been nationally recognized by Leapfrog's Hospital Safety Grade A. We offer a full array of services including 24/7 emergency care, open heart surgery, cardiac catheterizations, inpatient rehabilitation, orthopedic surgery, cancer care, intensive care and inpatient and outpatient surgeries and procedures. Northeast Methodist Hospital is an accredited Chest Pain Center and is a Certified Stroke Center by The Joint Commission. We are recognized as an Accredited Heart Failure Center by the Healthcare Colloquium and as a Top Performer on Key Quality Measures® by The Joint Commission. Our hospital has received the Mission: Lifeline® Bronze Receiving Quality Achievement Award for implementing specific quality improvement measures outlined by the American Heart Association for the treatment of patients who suffer severe heart attacks and the Texas Award for Performance Excellence. For more information, please visit our website at xxxxxxxxxxx* and select Northeast Methodist 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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