Manager - Case Mgmt (RN or LCSW)
Company: St. Mary's Medical Center
Location: West Palm Beach
Posted on: November 18, 2023
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Job Description:
Summary
The individual in this position is responsible to facilitate care
along a continuum through effective resource coordination to help
patients achieve optimal health, access to care and appropriate
utilization of resources, balanced with the patient's resources and
right to self-determination. The individual in this position has
overall responsibility to ensure that care is provided at the
appropriate level of care based on medical necessity and assess the
patient for transition needs to promote timely throughput, safe
discharge and prevent avoidable readmissions. This position
integrates national standards for case management scope of services
including:
--- Provides assistance to the Director of Case Management in the
management of the department, but not limited to,
hiring/training/managing staff, schedule coordination, analysis and
reporting, interfacing, collaborating and working closely with the
other departments
--- Utilization Management supporting medical necessity and denial
prevention
--- Transition Management promoting appropriate length of stay,
readmission prevention and patient satisfaction
--- Care Coordination by demonstrating efficient throughput while
assuring care is sequenced and at the appropriate level of care
--- Accountable for compliance with state and federal regulatory
requirements, TJC accreditation standards and Tenet policy
--- Provides education to physicians, patients, families and
caregivers
--- Facilitates educational programs for Case Management Department
on community resources use in discharge planning that encourages
professional growth
--- Provides reports to DCM and hospital leadership as
requested
The individual's responsibilities include the following activities:
a) assist the Director in the daily operations of the department b)
accurate medical necessity screening and submission for Physician
Advisor review, c) transition planning assessment and reassessment,
d) implementation or oversight of implementation of the transition
plan, e) leading and facilitating multi-disciplinary patient care
conferences, f) managing concurrent disputes, g) making appropriate
referrals to other departments, h) identification and reporting
over and underutilization, i) communicating with patients and
families about the plan of care, j) collaborating with physicians,
office staff and ancillary departments, k) leading and facilitating
Complex Case Review, l) assuring patient education is completed to
support post-acute needs , m) timely complete and concise
documentation in Tenet Case Management documentation system, n )
maintenance of accurate patient demographic and insurance
information, o) identification and documentation of potentially
avoidable days, p) and other duties as assigned.
Qualifications
Education
Required qualifications include an active Registered Nurse license
with B.S.N. preferred, ***unless higher degree required for Magnet
Hospital Status. Accredited Case Manager (ACM) preferred
Experience
At least two years acute hospital patient care, hospital case
management, healthcare, or leadership experience. Acute hospital
case management experience preferred.
License
Registered Nurse
Certification
BLS (AMERICAN HEART ASSN)
#LI-BB2
Tenet complies with federal, state, and/or local laws regarding
mandatory vaccination of its workforce. If you are offered this
position and must be vaccinated under any applicable law, you will
be required to show proof of full vaccination or obtain an approval
of a religious or medical exemption prior to your start date. If
you receive an exemption from the vaccination requirement, you will
be required to submit to regular testing in accordance with the
law.
2305027039
Employment practices will not be influenced or affected by an
applicant's or employee'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.
Keywords: St. Mary's Medical Center, Miami , Manager - Case Mgmt (RN or LCSW), Executive , West Palm Beach, Florida
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