Observation Unit Case Manager

Gonzaba Medical Group•San Antonio, TX

1d•Onsite

About The Position

This position coordinates and facilitates the delivery of quality, cost-effective patient care within the observation setting. This role ensures timely transitions of care by collaborating with physicians, nursing, and interdisciplinary teams to manage patient flow, ensure appropriate level of care, and plan for safe discharge or admission as indicated. The role involves conducting timely assessments of patients admitted to the Observation Unit and Urgent Care to determine appropriate level of care and potential discharge needs. It requires collaboration with providers to ensure observation status is clinically appropriate and complies with regulatory guidelines, and facilitating communication between medical staff, nursing, ancillary departments, and external agencies to support continuity of care. The Case Manager develops and implements individualized discharge plans based on patient needs, available resources, and insurance requirements, coordinating post-acute services such as home health, DME, outpatient follow-up, and transportation. Patient and family education regarding care plans, expected outcomes, and community resources is also a key aspect. The position partners with nursing leadership to identify and resolve barriers to patient flow and serves as a resource to clinical staff regarding observation criteria and discharge planning. Additionally, the role involves setting clear performance goals aligned with department objectives and conducting performance evaluations and providing coaching for professional growth.

Requirements

Communicate effectively with interdisciplinary teams, patients, and families.
Navigate complex situations with professionalism and critical thinking.
Strong organizational, time management, and problem-solving abilities.
Proficiency in electronic health record (EHR) systems and Microsoft Office applications.
A graduate of an accredited RN or LVN program and possess a current TX RN or LVN License, or related associate’s degree from an accredited vocational institution or military equivalent training.
CPR/Basic Cardiac Life Support Certification.
Must be able to communicate effectively in both written and verbal forms.
Skilled in use of computer/EMR systems.
Knowledge of Word processing software, spreadsheet software, Internet, and database software.
Requires manual dexterity, sitting, standing, stooping, reaching, kneeling, crouching, bending, walking, lifting up to 40 lbs. without assistance.
Close vision and ability to adjust focus.
Must be able to work efficiently under pressure.

Nice To Haves

Knowledge of case management, laboratory service, quality management, utilization management and risk management.
Experience in a clinic, doctor’s office or hospital with a minimum of one-year experience.

Responsibilities

All duties performed will be done accurately and in a timely manner.
Assess clinical and psychosocial patient needs.
Develop and implement individualized care transition plans.
Conduct timely assessments of patients admitted to the Observation Unit and Urgent Care to determine appropriate level of care and potential discharge needs.
Collaborate with providers to ensure observation status is clinically appropriate and complies with regulatory guidelines.
Facilitate communication between medical staff, nursing, ancillary departments, and external agencies to support continuity of care.
Develop and implement individualized discharge plans based on patient needs, available resources, and insurance requirements.
Coordinate post-acute services including home health, DME, outpatient follow-up, and transportation.
Educate patients and families regarding care plans, expected outcomes, and community resources.
Partner with nursing leadership to identify and resolve barriers to patient flow.
Serve as a resource to clinical staff regarding observation criteria and discharge planning.
Set clear performance goals aligned with department objectives.
Conduct performance evaluations and provide coaching for professional growth.
Other duties as assigned.
Required to provided bed-side nursing when needed or during peak volume hours.