As the flagship hospital of the Medical Center and of the Methodist Healthcare system of hospitals, we appreciate the support and recognition we receive from the community having been ranked No. 1 in the Express-News Reader's Choice Awards. We also enjoy being the most preferred hospital in San Antonio, as consistently reported by the Consumer Research Corporation. Methodist Hospital has been nationally recognized by Leapfrog’s Hospital Safety Grade A, accredited by the Joint Commission in stroke care, and designated as an accredited Chest Pain Center. For more information, please visit our website at www.sahealth.com and select Methodist Hospital under Locations.
Medical, Dental, disability and life insurance
Your Role: RN Case Manager - Case Management
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.
Utilize community resources to support patient’s post hospital needs. Documents choice in available resources has been offered.
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.
Facilitates and or provides education of hospital staff, physicians, patients and caregivers for purposes of efficient resource utilization
Keeps current of requirements by JCAHO, HCFA and other state/federal agencies on provision of 2
Tracks resource statistics to identify improvement opportunities. Attends medical staff and other hospital committee meetings to report findings.
Graduate of an accredited diploma, associates, or baccalaureate degree nursing program.
Minimum of 3 years clinical experience in area in which Case Management will be performed.
Employee completes initial and ongoing training and competencies as defined by service line, facility and department/unit which are specific to the needs of the patient population served (if applicable).
License and Certification:
Current Texas licensure as a Registered Nurse
Prefer at least one year experience in utilization review, resource management, discharge planning or case management.
Bachelor of Science in Nursing
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