Parkland Health-posted 2 months ago
Dallas, TX
Hospitals

Interested in a career with both meaning and growth? Whether your abilities are in direct patient care or one of the many other areas of healthcare administration and support, everyone at Parkland works together to fulfill our mission: the health and well-being of individuals and communities entrusted to our care. By joining Parkland, you become part of a diverse healthcare legacy that's served our community for more than 125 years. Put your skills to work with us, seek opportunities to learn and join a talented team where patient care is more than a job. It's our passion. The primary purpose of this position is to establish and maintain an efficient, cost-effective care management process by determining patient financial and medical eligibility, medical necessity, and by developing, implementing and monitoring individual patient plans of care and communicating these plans to patients, families, and Parkland staff to ensure quality patient care throughout the healthcare continuum and compliance with program/Parkland policies and procedures. Responsible for maintaining the knowledge and skill set related to utilization review, care coordination, performance improvement and professional licensure and certification.

  • Conducts assessment of patients on assigned Care Coordination team to develop a case management plan of care.
  • Collaborates with all members of the multidisciplinary team and the patient to implement the plan of care.
  • Communicates plan of care to patient and their family providing updates and reassesses the plan of care to determine effectiveness.
  • Collaborates with the healthcare team to identify 'best' practices for achieving patient outcomes.
  • Responsible for Utilization Management activities for assigned patients.
  • Monitors and addresses outcome variances.
  • Seeks the most efficient, cost effective ways to provide appropriate care.
  • Communicates with Care Management team to facilitate covered-day reimbursement certification and/or authorization for assigned patients.
  • Transitions patients through the health care system based upon individual and patient population needs.
  • Engages in special projects and serves on committees, as assigned.
  • Must be a graduate of an accredited school of Nursing.
  • Must have two (2) years of hospital or community based patient care nursing, preferably in assigned clinical area.
  • Must have current, valid RN license or temporary RN license from the Texas Board of Nursing; or, valid Compact RN license.
  • Must have current healthcare provider BLS for Healthcare Providers certification from an approved organization.
  • Demonstrated knowledge of disease processes affecting specific patient populations.
  • Working knowledge of laws and regulations governing Medicare, Medicaid and community-based funding sources.
  • Ability to communicate and collaborate effectively with a diverse group of patients, families and healthcare staff.
  • Self-directed and capable of priority setting and problem solving.
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