Description
Manages cases to enhance the quality of patient management and satisfaction. Promotes continuity of care and cost effectiveness through integrating functions of case management, utilization review and management, and discharge planning.
Responsibilities
- Provides ongoing support and expertise through comprehensive assessment, planning, implementation and overall evaluation of individual patient needs; accountable for the care, coordination and discharge planning of all patients.
- Coordinates the integration of social services/case management functions into the patient care, discharge, home planning processes, external service organizations, agencies and healthcare facilities.
- Acts as patient advocate; investigates and reports adverse occurrences; evaluates patient satisfaction and quality of care provided.
- Conducts review for appropriate utilization of services from admission through discharge; ensures that patient tests are appropriate and necessary, completed within the established timeframe and that results are promptly available.
- Performs staff education related to resource utilization, discharge planning and psychosocial aspects of healthcare delivery.
- Communicates with physicians at regular intervals and develops effective working relationships; assists physicians to maintain appropriate cost, case, and desired patient outcomes.
- Directs and participates in the development and implementation of patient care policies and protocols.
- Performs all other duties as assigned.
Qualifications
- Knowledge in a supervisory or quality assurance position in a healthcare environment.
- Case management experience.
- Knowledge as Registered Nurse in a clinical care setting.
- Good interpersonal skills.
- Utilizes influencing/motivational interviewing skills.
- Ability to speak, read, write, and communicate effectively.
- Ability to coordinate, analyze, observe, make decisions, and meet deadlines in a detail-oriented manner.
- Ability to work independently without supervision.
- Ability to manage multiple priorities, effective organizational and time management skills along with strong teamwork skills.
- Effective computer skills using Microsoft Office (Word, Excel, PowerPoint, etc.) and database software.
EDUCATION:
- Associate's degree in nursing is required.
Expereince:
Three (3) years of nursing experience in a clinic or hospital setting, to preferably include one (1) year of experience in a related patient population (such as utilization management, chronic disease management, home health, hospice).Ā Ā
LICENSE AND CERTIFICATION:
- Current Texas Registered Nurse License is required.