RN Case Manager - (US-TX-San Antonio - 78299)

Minimum Education: None
Jobcode: 60018288
Email this job to yourself or to a friend | Job Match Test | Resume Guide

X Navigates electronic facility portals, identifies email of census and e-mail phone notifications in daily identification of new admissions. X Provides assistance to attending physicians in arranging services for prospective, concurrent and retrospective reviews for in-patients and complete transition of care to out-patient care. X Becomes familiar with network providers for discharge planning purposes. X Performs discharge planning with patient/family, attending physician and facility case manager. X Attends, observes and reports accurate clinical review of hospitalized patients at PCC through the direction of the Case Management Trainer. X Monitors in-patient setting to identify potential early-discharge candidates to facilitate cost effective quality care and preventing inappropriate hospital admissions according to approved standardized guidelines. X Learns coverage of services according to health plan benefits and delivers accurate interpretation to customers. Quality X Reports quality of care issues to management and health plan per compliance guidelines through the direction of the Case Management Trainer. X Maintains and stores all supplies and equipment in a safe manner to eliminate theft and reduce safety risks to others. X Strives to personally expand working knowledge of all aspects of departments. X Attends and contributes to department meetings. X Attends educational offerings to keep abreast of change and complies with licensing requirements. Customer Service X Performs all duties to customers in a prompt, pleasant, professional and responsible manner regardless of the stressful nature of the situation and always identifies self by name and title. X Respects customer and organizational confidentiality. Compliance X Learns and understands all established and new or revised WellMed corporate and departmental policies and procedures when posted or distributed and the need for compliance through the direction of the Case Management Trainer. X Takes ownership of the total work process and provides constructive information to minimize problems and increase customer satisfaction and seek ways to improve job efficiency and makes suggestions to the appropriate manager as understanding of position is completed. X Learns and follows facility policy for onsite reviewer conducting rounds. X Begins utilizing approved standardized guidelines in determining appropriateness of admission and level of discharge care. Enters timely, accurate, and concurrent information into Case Management Documentation System (CMDS) for review through the direction of the Case Management Trainer.

Compensation: $22.63hr-$27.11hr

Experience: X Current RN Licensure required (specific to the state of employment)
X Up to two years of case management experience or experience in ICU, CCU or ER.
X Knowledge of managed care, medical terminology, referral process, claims and ICD-9 codes.
X Excellent verbal and written skills.
X Possesses planning, organizing, conflict resolution, negotiation and interpersonal skills to work with autonomy in meeting compliance goals.
X Possesses problem identification/resolution and decision-making skills and can work collaboratively with other utilization management staff for an overall team approach to case management.
X Proficient computer skills and willingness to improve skills through formal training available by WellMed.
X Ability to interact productively with individuals and with multidisciplinary teams.

Preferred Education, Experience & Skills
X More than two years of case management experience or experience in hospital nursing.

This job has been posted on Absolutely Health Care to Nurse: Case Manager.