Case Management

United Surgical Partners International • Sherman, TX

66d

About The Position

The position involves facilitating progress through the continuum of care, from Pre-Admission through Discharge. The role includes providing feedback to payors on the patient's clinical status and securing approvals for additional days of stay. The individual will monitor quality standards as determined by the Performance Improvement Plan and the Medical Staff Quality Indicators. Evaluating patients for discharge planning needs and appropriately directing the patient's care is essential. The position also requires monitoring resource consumption for the most effective use, identifying teaching and psychosocial concerns for the best patient outcomes, assisting in aggregating data for quality trending, and assisting in Infection Control surveillance. Additionally, the individual will function as a Patient Advocate to assist patients in resolving concerns.

Requirements

• Graduate of an accredited school of Nursing
• Current RN license required
• Insurance knowledge
• Excellent phone skills

Nice To Haves

• Previous experience in case management preferred
• Certification preferred but not required
• Acute care experience
• 2-5 years in case management preferred
• 3-5 years nursing experience preferred

Responsibilities

• Facilitates progress through the continuum of care, from Pre-Admission through Discharge
• Provides feedback to payors on patient's clinical status and secures approvals for additional days of stay
• Monitors quality standards as determined by the Performance Improvement Plan and the Medical Staff Quality Indicators
• Evaluates patients for discharge planning needs and appropriately directs the patient's care
• Monitors resource consumption for most effective use
• Identifies teaching and psychosocial concerns for the best patient outcomes
• Assists in aggregating data for quality trending
• Assists in Infection Control surveillance
• Functions as a Patient Advocate to assist patients in resolving concerns

What This Job Offers

• Industry: Hospitals
• Education Level: Bachelor's degree
• Number of Employees: 5,001-10,000 employees