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RN Care Coordinators arrange and ensure all elements of the transition plan are implemented and communicated to key stakeholders including, but not limited to, the health care team, patient/family/ caregiver, and post-acute providers.
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Solid clinician skills with in-depth knowledge of all aspects of care coordination, long-term care, acute care, and pharmacy services. Facilitates integration of care coordination, long-term care, acute and pharmacy services.
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Deliver on Acute Care goals and metrics for accounts within assigned geography. Support internal and external education on Enablement Function process, tool optimization, and utilization in collaboration with Medical Education, Sales Education and Marketing Communications partners.
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Methodist Charlton Medical Center is a 314-bed, full-service, acute care teaching hospital that serves Cedar Hill, DeSoto, Duncanville, and Lancaster in southwestern Dallas County. The Care Transitions Navigator will coordinate activities that promote quality outcomes, patient throughput and discharge planning while supporting a balance of optimal care and appropriate resource utilization.
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Provides analysis and education regarding regulatory and clinical changes impacting inpatient and post-acute care processes and reimbursement. Lead Tenet Utilization Review Teams market structure and operations management to effectively support utilization review and authorization confirmation functions to promote an appropriate level of care and prevent payer denials.
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1+ years of Med Surg experience in a acute care with inpatient in a hospital setting. Facilitation of Learning: Facilitates learning for patients and families, nursing staff, other members of the health care team and community; integrating appropriate education throughout the continuum of care to help them participate and/or make informed conclusions about their health care and treatments, including health promotion and disease prevention.
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Demonstrates exemplary knowledge of utilization management and care coordination processes as a foundation for transition planning activities. Actively implements a plan of care utilizing approved clinical guidelines to transition and provide continuity of care for members to an appropriate lower level of care in collaboration with the hospitals/physician team, acute or skilled facility staff, ambulatory care team, and the member and/or family/caregiver.
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At least 4 years job related experience in case management, utilization management, acute care or quality improvement in a healthcare environment required. Coach and mentor staff on care coordination and early intervention for discharge planning; assist in difficult situations and discharges.
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Keeps current on all Federal, State and local regulatory changes that affect delivery or reimbursement of acute care services within the scope of Utilization Management. Conduct medical certification review for medical necessity for acute care facility and services.
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Ability to transition between multiple programs on any given day · Understanding of IPR post-acute guidelines; utilization of CARE tool assessment Facility Location Situated among an abundance of lakes, hills and lush greenery, the capital of Texas is home to a diverse culture and is a refuge for outdoor enthusiasts and music lovers.
$1,586.19 - $1,827.57 a weekFull-timeExpandApply NowActive JobUpdated 1 month ago - UpvoteDownvoteShare Job
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Engage acute and post-acute partners in managing high risk patients through next site of care planning, performance network utilization,management of SNF performance metrics and continuous outcomes and financial improvement.
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Assist in the design/development of standardized reports relative to acute episodes of care by physician, payer, diagnosis, MS-DRG, MDC, utilization, as well as variable direct and indirect costing methods to provide practical tools for providers to monitor medical resource consumption and assist in maximizing clinical quality and financial outcomes.
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PBHN is composed of 100+ physicians that support Tenet's five South Florida acute care hospitals throughout Broward and Palm Beach counties. Join Tenet Healt as a dedicated Utilization Review Physician Advisor serving two of our premier Florida facilities.
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Prefer experience in an acute care setting. Whether your abilities are in direct patient care or one of the many other areas of healthcare administration and support, everyone at Parkland works together to fulfill our mission: the health and well-being of individuals and communities entrusted to our care.
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The RN Case Manager II - Inpatient Services performs onsite review or telephonic clinical review of inpatient admissions in an acute hospital, rehabilitation facility, LTAC or skilled nursing facility.
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acute care utilization jobs in Irving, TX
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