RN / Case Management Job in Houston, Texas / Hospital
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Description
Standard Qualifications: This is for a Denials CM or RAC background. Park Plaza & Plaza Specialty Hospitals - Houston, TX Registered Nurse (RN) Case Manager - Utilization Review Located adjacent to the Texas Medical Center, Park Plaza and Plaza Specialty Hospitals offer the convenience of a community hospital with two distinct purposes. Since 1975, Park Plaza Hospital has been offering complete medical services, including surgery as well as outpatient, imaging and rehabilitation. Plaza Specialty Hospital, a hospital within a hospital, has been providing long-term acute care to those needing prolonged hospitalization and recovery since 1994. Park Plaza/Plaza Specialty Hospital is currently looking for a Registered Nurse (RN) - Utilization Review. Responsibilities: Assists patient/family in utilizing and accessing relevant and appropriate community resources Evaluates psychosocial and medical/nursing information to determine an appropriate discharge plan Documents information within the Case Management database to ensure communication of patients needs posthospitalization is met. Performs supportive counseling to assist patients/families in adjusting to diagnosis and illness in an effort to meet realistic planning goals Performs admission, continued stay and discharge reviews for appropraietness and necessity of continued stays utilizing medical staff and hospital approved criterion (Interqual) Ensure that the appropriate decision makers are informed and involved in treatment planning. Performs admission and discharge(if required or changed) psychosocial assessments of patient/family situations including social, psychological, emotional , financial and other related factors to facilitate patients' return to optimal level within the community. Adheres to departmental, hospital and health system's policies and procedures Attends meetings and prepares and presents reports as assigned. Effectively communicates with team members Performs all duties as assigned.
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