Pre-Surgical Optimization Care Manager
About The Position
The Pre-Surgical Optimization Care Manager is critical for working with assigned patients, assessing, facilitating, planning, and advocating health needs on an individual basis. In this role you will manage, coordinate and perform duties to gather information and support pre-certification and authorization of surgery and post-op care. This role will also meet established organizational goals as outlined in Franciscan Values and Service Standards and will have the ability to build positive relationships, affect change, perform critical analysis, plan and organize, and promote beneficiary and family autonomy. WHO WE ARE Franciscan Health is a leading healthcare organization dedicated to providing exceptional patient care and promoting health and wellness in our community. Our mission is to ensure that every patient receives the highest quality of care through innovation, compassion, and excellence. With 12 ministries and access points across Indiana and Illinois, Franciscan Health is one of the largest Catholic health care systems in the Midwest. Franciscan Health takes pride in hiring coworkers who provide compassionate, comprehensive care for our patients and the communities we serve. WHAT YOU CAN EXPECT Connect with patient and family to complete psychosocial history and assess patient pre/post-surgical needs. Review computer record and chart and become familiar with the patient's history and current circumstances. Assess the Plan of Care to meet patient needs. Apply criteria and clinical guidelines, standardized care management plans, polices, procedures and regulatory standards while assessing patient's needs to ensure appropriate administration of benefits and surgical procedure and post-care coverage. Apply clinical judgment to the incorporation of strategies designed to reduce risk factors and barriers and address complex health and social indicators which impact care planning and resolution of member issues Communicate with physicians, the OR/PACU/SDS/Endoscopy staff, Anesthesia, CRNAs, ancillary departments, physicians' office staff, contractual associates, other hospitals, sales representatives, as well as nursing and ancillary services to effectively and efficiently deliver surgical services to patients. Communicate with appropriate Post-Acute (Home Health, Skilled Nursing Facility, PT/OT, DME) resources to support delivery of care, positive outcomes and transition of care.
Requirements
- Bachelor's Degree, Registered Nurse (RN) - Required
- Registered Nurse (RN) - State Licensing Board - Required
- Strong multitasking abilities with excellent organizational skills - Required
- Effective verbal and written communication skills - Required
Nice To Haves
- 2 years Case Management Preferred
Responsibilities
- Connect with patient and family to complete psychosocial history and assess patient pre/post-surgical needs.
- Review computer record and chart and become familiar with the patient's history and current circumstances.
- Assess the Plan of Care to meet patient needs.
- Apply criteria and clinical guidelines, standardized care management plans, polices, procedures and regulatory standards while assessing patient's needs to ensure appropriate administration of benefits and surgical procedure and post-care coverage.
- Apply clinical judgment to the incorporation of strategies designed to reduce risk factors and barriers and address complex health and social indicators which impact care planning and resolution of member issues
- Communicate with physicians, the OR/PACU/SDS/Endoscopy staff, Anesthesia, CRNAs, ancillary departments, physicians' office staff, contractual associates, other hospitals, sales representatives, as well as nursing and ancillary services to effectively and efficiently deliver surgical services to patients.
- Communicate with appropriate Post-Acute (Home Health, Skilled Nursing Facility, PT/OT, DME) resources to support delivery of care, positive outcomes and transition of care.
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What This Job Offers
Job Type
Full-time
Industry
Hospitals
Number of Employees
5,001-10,000 employees
