At Methodist Specialty and Transplant Hospital, we recognize the unique needs of each of our patients. It's an extraordinary effort that we continue to improve upon, creating ways to better serve our community when they need us most. Methodist Specialty and Transplant Hospital receives international acclaim for its outstanding and dynamic kidney, liver and pancreas transplant programs, setting record numbers for volume and outcomes. Methodist Specialty and Transplant Hospital is home to the Texas Transplant Institute, a nationally recognized center that recently performed the world's first 16-way kidney donor exchange chain during three consecutive days at a single hospital. Methodist Specialty and Transplant Hospital earned designation as a Center of Metabolic and Bariatric Surgery Excellence from the American Society for Bariatric Surgery in 2008. Our Sexual Assault Response Team provides a compassionate environment for sexual assault survivors ages 13 and up. This program serves as a model for hospitals and agencies all over the world. Our hospital provides patient-centered care with a staff of professionals who genuinely care for the well-being of others. As part of Methodist Healthcare's mission of Serving Humanity to Honor God, we strive to offer care in a safe and compassionate environment. Additional hospital specialties include psychiatric services, emergency care, rehabilitation and robotic surgery.
General Statement of Duties:
The Case Manager will work with patient/families identified to have discharge planning, psychosocial, financial or other needs to develop a plan that will:
1) Optimize functional and self-care abilities;
2) facilitate system access and appropriate utilization of services;
3) facilitate communication and coordination of efforts among health care team members; and
4) promote quality, cost effective outcomes. The Case Manager will demonstrate knowledge and skills necessary to develop a plan based on physical, psychosocial, educational and age related criteria
Essential Job Functions:
1. Assesses by interview and charts review discharge needs of all high-risk patients (and others referred). Identifies resources available to address the needs identified, coordinate referrals and document plan.
2. Utilize community resources to support patient's post hospital needs. Documents choice in available resources has been offered.
3. Performs admission and continued stay reviews. Provides clinical information to payers upon request for certification and reimbursement of care. Discusses alternate level of care with physician. Refers cases not meeting acute care criteria to Physician Advisor as needed.
4. Facilitates and or provides education of hospital staff, physicians, patients and caregivers for purposes of efficient resource utilization
5. Keeps current of requirements by JCAHO, HCFA and other state/federal agencies on provision of care, planning and documenting.
6. Tracks resource statistics to identify improvement opportunities. Attends medical staff and other hospital committee meetings to report findings.
Minimum Education, Experience, Training, Required Knowledge, Skill, Abilities and Other Job-Related Characteristics:
1. Education: Graduate of an accredited diploma, associates, or baccalaureate degree nursing program.
2. Experience: Minimum of 3 years clinical experience in area in which Case Management will be performed.
3. Employee completes initial and ongoing training and competencies as defined by service line, facility and department/unit which are specific to the needs of the patient population served (if applicable).
4. Preferred: Prefer at least one year experience in utilization review, resource management, discharge planning or case management.
Minimum License, Certificates, or Registrations Required:
1. Required: Current Texas licensure as a Registered Nurse
2. Preferred: Bachelor of Science in Nursing
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