HCA, Hospital Corporation of America Registered Nurse Case Manager - Full Time in San Antonio, Texas

Methodist Hospital opened in 1963 as the first hospital in the internationally acclaimed South Texas Medical Center. From the beginning, we've recognized the unique needs of each of our patients. It's a process that we continue to improve on, creating ways to better serve the community when they need us the most. Methodist Hospital offers a broad range of specialties including cardiology, bone marrow transplant, emergency medicine, neurosciences, maternity care, gynecology and orthopedics. Methodist Hospital is accredited by the Joint Commission in stroke care and is designated as an accredited Chest Pain Center. We deeply value our staff and our patients. As the flagship hospital of the Medical Center and of the Methodist Healthcare system of hospitals, we appreciate the support and recognition we receive from the community in being ranked No. 1 in the Express - News Reader's Choice Awards from 2009-2013. We also enjoy being the most preferred hospital in San Antonio, as consistently reported by the Consumer Research Corporation.

General Statement of Duties:

The Case Manager will work with patient/families identified to have discharge planning, psychosocial, financial or other needs to develop a plan that will:

1) Optimize functional and self-care abilities;

2) facilitate system access and appropriate utilization of services;

3) facilitate communication and coordination of efforts among health care team members; and

4) promote quality, cost effective outcomes. The Case Manager will demonstrate knowledge and skills necessary to develop a plan based on physical, psychosocial, educational and age related criteria

Essential Job Functions:

  1. Assesses by interview and charts review discharge needs of all high-risk patients (and others referred). Identifies resources available to address the needs identified, coordinate referrals and document plan.

  2. Utilize community resources to support patient’s post hospital needs. Documents choice in available resources has been offered.

  3. Performs admission and continued stay reviews. Provides clinical information to payers upon request for certification and reimbursement of care. Discusses alternate level of care with physician. Refers cases not meeting acute care criteria to Physician Advisor as needed.

  4. Facilitates and or provides education of hospital staff, physicians, patients and caregivers for purposes of efficient resource utilization

  5. Keeps current of requirements by JCAHO, HCFA and other state/federal agencies on provision of care, planning and documenting.

  6. Tracks resource statistics to identify improvement opportunities. Attends medical staff and other hospital committee meetings to report findings.

Minimum Education, Experience, Training, Required Knowledge, Skill, Abilities and Other Job-Related Characteristics:

  1. Education: Graduate of an accredited diploma, associates, or baccalaureate degree nursing program.

  2. Experience: Minimum of 3 years clinical experience in area in which Case Management will be performed.

  3. Employee completes initial and ongoing training and competencies as defined by service line, facility and department/unit which are specific to the needs of the patient population served (if applicable).

  4. Preferred: Prefer at least one year experience in utilization review, resource management, discharge planning or case management.

Minimum License, Certificates, or Registrations Required:

  1. Required: Current Texas licensure as a Registered Nurse

  2. Preferred: Bachelor of Science in Nursing

Title: Registered Nurse Case Manager - Full Time

Location: Texas-San Antonio-Methodist Hospital

Requisition ID: 02531-78414