Location: Southwest General Hospital
Posted Date: 3/9/2020
The Case Manager will assume primary responsibility of cases for documentation of appropriate medical necessity for the inpatient or observation status. Communicates with physician, ancillary staff, and payers and assists in arranging transfersor alternate placement when indicated. Assures proper level of care assignment. Facilitates with Case Managers and other allied health professionals to promote and ensure that quality care is provided and outcomes are achieved in a timely and cost-effectivemanner. Utilizes a complete and systematic methodology/process to assess, plan, implement, evaluate and provide patient care coordination for patients from pre-hospital through post-hospital aftercare. Assists in the development of physician profiles to identifyover/under utilization patterns. Promotes appropriate post-hospital utilization of resources, adequate education of patient and hospital staff, and decreased incidence of re-admissions. Supports hospital goals and objectives in compliance with regulatory guidelines.The Case Manager will work in collaboration with all healthcare disciplines to assure a continuum of appropriate and timely services. to assess the medical appropriateness, quality, and cost-effectiveness of proposed hospital, medical, and surgical services inaccordance with established criteria. Collaborates with the multidisciplinary team to assist patient with benefits resource management, evaluating appropriateness of the level of care, and communicating with the payer to obtain authorization. Identifies and plansstrategies to reduce inpatient length of stay and resource consumption.
1. Graduate of an accredited school of nursing
2. 3 years recent acute care nursing experience required. General medical Surgical and/or Critical nursing preferred. Utilization and managed care experience desirable.
3. Licensed by the State of Texas as a registered Nurse(Case Manager Certification preferred.)
4. Education regarding Stroke Awareness must be completed within 6 months of hire.
Steward Health Care complies with applicable Federal and State civil rights laws and does not discriminate on the basis of race, color, national origin, citizenship, alienage, religion, creed, sex, sexual orientation, gender identity, age or disability. Steward Health Care does not exclude people or treat them differently because of race, color, national origin, citizenship, alienage, religion, creed, sex, sexual orientation, gender identity, age or disability.