The individual in this position has overall responsibility for coordinating the daily activities of the case management team, while overseeing the clinical plan of care to conform with evidence-based practice and/or regulatory/payor requirements. This position integrates functions typically considered to be case management, care coordination and/or utilization management, and discharge planning assessment and coordination.
As such, the individualï¿½s responsibilities will include, but not be limited to the following activities:
Coordination of clinical care (medical necessity, appropriateness of care and resource utilization for admission, continued stay, discharge and post-acute care) compared to evidenced-based practice, internal and external requirements.
Identify and report variances in appropriateness of medical care provided, over/under utilization of resources compared to evidenced-based practice and external requirements.
This priority includes work with relevant software and communicating information through clear, complete and concise documentation in CM software.
Effective collaboration with physicians, nurses, ancillary staff, payors, patients and families to achieve optimum clinical outcomes.
Remain current with relevant clinical / case management practices.
Assist Director with daily operational oversight and supervision of Departmental staff.
Required: Preferred: Bachelor of Science in Nursing (BSN) preferred.
Required: Two (2) years acute hospital case management, healthcare or leadership experience. McKesson InterQualï¿½ experience preferred. Five years (5) acute hospital case management experience preferred.
Required: Active Registered Nurse license. BLS required within 10 days of hire or transfer into unit. Preferred: Accredited Case Manager (ACM)
Job: Managers and Directors
Primary Location: Brownsville, Texas
Facility: Valley Baptist Medical Center - Brownsville
Job Type: Full-time
Shift Type: Days
Employment practices will not be influenced or affected by an applicantâ��s or employeeâ��s race, color, religion, sex (including pregnancy), national origin, age, disability, genetic information, sexual orientation, gender identity or expression, veteran status or any other legally protected status. Tenet will make reasonable accommodations for qualified individuals with disabilities unless doing so would result in an undue hardship.
Internal Number: 2005001679
About Valley Baptist Medical Center - Brownsville
“Tenet Healthcare Corporation is a diversified healthcare services company with 115,000 employees united around a common mission: to help people live happier, healthier lives. Through its subsidiaries, partnerships and joint ventures, including United Surgical Partners International, the Company operates general acute care and specialty hospitals, ambulatory surgery centers, urgent care centers and other outpatient facilities. Tenet's Conifer Health Solutions subsidiary provides technology-enabled performance improvement and health management solutions to hospitals, health systems, integrated delivery networks, physician groups, self-insured organizations and health plans.