SCOPE OF CARE:
The Case Management Department specifically focuses on accountability of coordination of patient care throughout the continuum, which facilitates the achievement of quality patient outcomes and high customer satisfaction. Ongoing concurrent review of patients status, necessity for hospitalization and extended lengths of stay, evaluation of patient treatment with respect to the timelines of use and the under/over utilization of diagnostic or therapeutic services, to conduct concurrent and retrospective reviews of patient care and development monitoring procedures for the evaluation of quality and efficiency of patient care and to review all denials of reimbursement and allow for appeals and denials.
Psycho Social Assessment, Utilization Review and Management, Discharge Planning, Clinical, Denial, and Outcomes Management.
Patient Population Served:
Acute Care, Labor and Delivery, Newborn, NICU, Center for Behavioral Health, Acute Rehabilitation Unit and the Transitional Care Unit.
Hours of Operation:
Monday - Friday 8:00 a.m. - 5:00 p.m.
Saturday - Weekend Case Manager 8:30 a.m. - 5:00 p.m.
Sunday - Weekend Case Manager 8:30 a.m. - 5:00 p.m.
Emergency Department 24/7
Monday - Friday Social Worker on call up to 9:00 p.m.
Weekends - Social Worker on call.
An Administrative Director is responsible for the Case Management Department. The Chief Financial Officer provides Administrative support.
Staffing Skill Mix/Qualifications:
The Case Management Department staffing includes Registered Nurses and Social Workers in all areas, with the exception of an LVN in the Transfer Center and a Licensed Therapist in Behavioral Health.
Plan for Modifying Staffing to Meet Patient/Process Needs:
Case Managers and Social Workers are unit based; assignments are modified to meet volumes.
Assessments and Reassessment Practices/Timeframe:
Assessments are completed within 24-48 hours of admission; Reassessments may occur when Family, Physician, Patient and Interdisciplinary Rounding team makes a recommendation or change in patients plan.
Two years of recent hospital experience in a Case Manager role highly desired.
Current RN licensure issued by the Board of Nurse Examiners issued by the State of Texas.
EDUCATION & TRAINING:
Level of knowledge normally acquired through the completion of a Bachelor’s Degree in Nursing from an accredited School of Nursing.
- Technical, critical thinking and interpersonal skills relevant to clinical area in order to effectively communicate with patients and physicians.
- Ability to speak clearly enabling patients and the like easy comprehension.
- Ability to write and print legibly.
- Demonstration of customer focused skills.
Case Manager, RN
St. Joseph Medical Center
PRN/On Call Paid no/BN no/TA
- 22 months ago - save job
For 125 years St. Joseph Medical Center has provided an ever-increasing range of services to residents in the Greater Houston area. As the...