Registered Nurse Case Manager

Conifer Health Solutions•San Antonio, TX

7d•Onsite

About The Position

Responsible to facilitate care along a continuum through effective resource coordination to help patients achieve optimal health, access to care and appropriate utilization of resources balanced with the patient’s resources and right to self-determination. Has overall responsibility to ensure that care is provided at the appropriate level of care based on medical necessity and assess the patient for transition needs to promote timely throughput, safe discharge and prevent avoidable readmissions. This position integrates national standards for case management scope of services including: Provides assistance to the Director of Case Management in the management of the department, but not limited to, hiring/training/managing staff, schedule coordination, analysis and reporting, interfacing, collaborating and working closely with the other departments; Utilization Management supporting medical necessity and denial prevention; Transition Management promoting appropriate length of stay, readmission prevention and patient satisfaction; Care Coordination by demonstrating efficient throughput while assuring care is sequenced and at the appropriate level of care; Compliance with state and federal regulatory requirements, TJC accreditation standards and Tenet policy; Provides education to physicians, patients, families and caregivers; Facilitates education programs for Case Management Department on community resources use in discharge planning that encourages professional growth; Provides reports to DCM and hospital leadership. Completes established competencies for the position within designated introductory period. Other related duties as assigned.

Requirements

Graduate of an accredited School for Nursing
2 years of acute hospital patient care, hospital case management, healthcare or leadership experience.
Demonstrates computer knowledge of programs related to position and displays competency on an ongoing basis.
Possession of current Texas State registration as a Registered Nurse

Nice To Haves

Bachelor’s Degree from accredited college or university for Nursing
Previous Case Management Supervisory experience
Certification in Case Management (CCM)

Responsibilities

Provides assistance to the Director of Case Management in the management of the department, but not limited to, hiring/training/managing staff, schedule coordination, analysis and reporting, interfacing, collaborating and working closely with the other departments
Utilization Management supporting medical necessity and denial prevention
Transition Management promoting appropriate length of stay, readmission prevention and patient satisfaction
Care Coordination by demonstrating efficient throughput while assuring care is sequenced and at the appropriate level of care
Compliance with state and federal regulatory requirements, TJC accreditation standards and Tenet policy
Provides education to physicians, patients, families and caregivers
Facilitates education programs for Case Management Department on community resources use in discharge planning that encourages professional growth
Provides reports to DCM and hospital leadership
Completes established competencies for the position within designated introductory period
Other related duties as assigned