100 Top Hospitals Seven Consecutive Years St. David's Medical Center is part of St. David's HealthCare, one of the largest health systems in Texas, which was recognized in 2014 with a Malcolm Baldrige National Quality Award . Founded in 1924, St. David's Medical Center is a full-service medical center offering comprehensive medical care at three locations-St. David's Medical Center, Heart Hospital of Austin and St. David's Georgetown Hospital .
Located in central Austin, St. David's Medical Center includes a 350-bed acute care hospital and a 64- bed rehabilitation hospital providing comprehensive inpatient and outpatient care. It is home to the internationally renowned Texas Cardiac Arrhythmia Institute and St. David's Neuroscience & Spine Institute . The hospital provides a complete range of women's services, including its acclaimed maternity unit, maternal-fetal medicine, a high-risk maternal and neonatal transport team, the region's largest and most sophisticated Neonatal Intensive Care Unit and The Breast Center ; complex surgical services; a comprehensive Bariatric Surgery Center ; and a 24-hour emergency department.
St. David's Medical Center was named among the nation's 100 Top Hospitals by Truven Health Analytics from 2010 to 2016. Truven also named St. David's Medical Center to the list of 50 Top Cardiovascular Hospitals in 2013, 2015 and 2016. The hospital earned a national distinction for patient safety from The Leapfrog Group from 2012 to 2016, and it received the 2016 Distinguished Hospital Award for Clinical Excellence from Healthgrades for the fifth consecutive year, as well as Healthgrades' 2016 America's 100 Best Hospitals Award™ for the second consecutive year.
POSITION SUMMARY :
The Case Management Manager works in conjunction with other members of the interdisciplinary care team using a proactive approach to facilitate effective and efficient patient care during the hospital stay. The Case Management Manager demonstrates initiative and self-direction in managing and providing oversight for the Case Management and Social Services Departments. This position is a working management position; the Case Management Manager will perform all functions of Case Management in addition to supervising and ensuring staffing in the departments.
ESSENTIAL JOB RESPONSIBILITIES :
1. The Case Management Manager works in conjunction with other members of the interdisciplinary care team using a proactive approach to facilitate effective and efficient patient care during the hospital stay.
a. Facilitate effective and efficient patient care during the hospital stay. Face-to-face visit with patients and/or family members for comprehensive assessment for discharge needs taking into account the patient's needs, current and prospective functional capacities, resources and support systems.
b. Follow-up visits and phone calls with patients and/or families as needed
c. Accurate and timely utilization review of patient charts to insure appropriate utilization of hospital resources and facilities
d. Provision of clinical information to 3rd party payers in support of the patient's admission and/or continued hospital stay
e. Active communication with the physicians regarding issues such as length of stay, admission and/or treatment criteria, and how to render services in the most cost effective setting
f. Comprehensive assessment that takes into account the patient's needs, current and prospective functional capacities, resources and support systems.
g. Collaborative formulation of appropriate and realistic patient-centered discharge plans including the arrangement of any necessary follow-up services such as durable medical equipment, home health and/or placement
h. Advocacy in support of the patient's right to self-determination
i. Acting as a liaison between patients, families, visitors, physicians, SDGH staff and/or other community service providers
j. Community information and referral
k. Thorough and timely documentation regarding the patient's problems, goals, plans and/or relevant case management interventions
l. Participation in and/or facilitation of interdisciplinary care conferences
2. Analyzes case management and social work functions and data.
a. Prepares and reviews data analyses related to the effective of services: length of stay, avoidable days, reimbursement, resource utilization, and variances.
b. Liaison between senior hospital management and departmental staff to communicate facility and departmental goals.
c. Maintains regular and candid communication with the director to advise of departmental priorities and challenges and to recommend improvements.
3. Provides oversight and direction of department operations.
a. Directs concurrent reviews to ensure timeliness and accuracy and intervenes when patients do not meet medical necessity. Oversees and monitors processes to manage and respond to denials.
b. Able to assist department with workload changes as appropriate and necessary to meet patient and facility demands.
c. Participates in annual budgeting process and monitors departmental adherence.
d. Maintains communication among staff members in the department.
e. Assists director with employee performance evaluations, counseling, and interview process.
4. Employee's conduct must reflect the Company's values and a commitment to the Code of Conduct ethics and compliance program.
5. Adheres and upholds all service behaviors as listed in the I CARE value commitment and other departmental initiatives.
6. Performs other duties as assigned or requested by senior hospital management.
Knowledge, Skills and Abilities :
Must be able to demonstrate understanding of HCA's and St. David's Georgetown Hospital "Patients First" safety initiative by strict compliance to all safety protocols and procedures.
Comprehends complex clinical data. Organizes, prioritizes, and manages time effectively.
Strong computer skills; ability to learn quickly and be flexible.
Requires effective interpersonal and communication skills, both written and verbally, and the discretion to manage confidential patient information from medical records and other internal and external sources.
Possesses the ability to make decisions of a highly complex nature with minimal direct supervision. Maintains strict confidentiality of all data and information. Exercises discretion in all interactions and maintains a reputation of trustworthiness among peers and medical staff.
Education and Experience :
Required: Bachelor's Degree in Nursing or Social Work. Must be able to communicate effectively both verb al ly and in writing. Advanced computer skills.
Preferred: 5 years of Case Management experience in an acute care setting; 2 years of supervisory or management experience
Licenses and Certificates :
Required: Current Texas RN, LMSW, or LCSW license
Preferred: Certification in Case Management
A little about us:
HCA is the nation’s leading private provider of healthcare services. Comprised of locally managed facilities which include 230,000 employees at over 160 hospitals, over 120 surgery centers and 100 urgent care facilities in 20 states and the United Kingdom