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Case Manager

Company: Presbyterian Healthcare Services
Location: socorro
Posted on: May 3, 2021

Job Description:

Overview

Situated near the center of the state, the City of Socorro sits at an elevation of approximately 4,500 feet keeping it safe from the snow of the north and spared from the heat of the south. With a population of approximately 19,000, the Socorro County area has rural community charm with convenient access to New Mexico's largest metropolitan area. Learn more about Socorro: Applies approved clinical criteria to monitor appropriateness of admissions and continued stays to ensure a clear status determination. Refers cases and issues to Case Management Medical Director based on departmental standards. Demonstrates skill in communicating with physicians the necessary documentation required to demonstrate medical necessity. Elevates to Supervisor and/or Medical Director all patients not meeting criteria after discussion with physician. Demonstrates skill in educating patient, family and interdisciplinary team regarding post-acute care options, status determination, and other care coordination services. Develops implements, coordinates, monitors and evaluates preliminary and final discharge plans with the interdisciplinary team, patient and family. Arranges and/or facilitates identified discharge needs and services of patients and ensures timely intervention to prevent delays in service and transition of care. Ensures all elements of the plan of care have been communicated to the patient/family and members of the healthcare team to assure continuity of care. Participates and facilitates care progression in daily multidisciplinary rounds and addresses target length of stay with health care providers to achieve complete delivery of services within prescribed timeframe. Monitors length of stay and takes action to mitigate overutilization and elevates to medical director as needed. Presents and actively participates in complex rounds, discharge planning huddles, process improvement teams, department specific initiatives and department meetings. Identifies patients and families with complex psychosocial issues and refers them to the Social Worker as appropriate. Demonstrates skill and success in collaboration with Social Work partner. Facilitates and leads patient/family and provider care conferences as needed. Documents results of assessments, status assignment, and interventions and discharge planning in the medical record according to departmental policies and procedures. Ensures safe care to patients adhering to policies, procedures, and standards within budgetary specifications, including time management, supply management, productivity and accuracy of practice. Promotes individual professional growth and development by meeting requirements for continuing education, skills competency, supports departmental based goals which contribute to the success of the organization. OP Infusion Care ManagerObtain prior authorization for medication or procedure, create referrals, scan orders into patient records, schedule appointments, communicate with all providers, and schedule outpatient appointments. Prior Authorization and Screening Swing Bed Patients Discharge Planner - Schedule OP appointments, order DME, Order HHC/PT, & Placement in Skilled Nursing, provide discharge instructions to patient and family and provide education. Other duties as assigned.

Qualifications

Education: Bachelors Degree required

Credentials: Registered Nurse-NM

Required Experience: BSN plus 3 years of clinical nursing experience; or ADN plus 5 years utilization review or case management experience required

Preferred Qualifications: National Case Management certification preferred.

Benefits

Benefits are effective day-one (for .45 FTE and above) and include:

  • Competitive salaries
  • Full medical, dental and vision insurance
  • Flexible spending accounts (FSAs)
  • Free wellness programs
  • Paid time off (PTO)
  • Retirement plans, including matching employer contributions
  • Continuing education and career development opportunities
  • Life insurance and short/long term disability programs

About Us Presbyterian Healthcare Services is a locally owned, not-for-profit healthcare system of nine hospitals, a statewide health plan and a growing multi-specialty medical group. Founded in New Mexico in 1908, it is the state's largest private employer with approximately 11,000 employees.

Presbyterian's story is really the story of the remarkable people who have chosen to work here. Starting with Reverend Cooper who began our journey in 1908, the hard work of thousands of physicians, employees, board members, and other volunteers brought Presbyterian from a tiny tuberculosis sanatorium to a statewide healthcare system, serving more than 700,000 New Mexicans. We are part of New Mexico's history - and committed to its future. That is why we will continue to work just as hard and care just as deeply to serve New Mexico for years to come. About New Mexico New Mexico's unique blend of Spanish, Mexican and Native American influences contribute to a culturally rich lifestyle. Add in Albuquerque's International Balloon Fiesta, Los Alamos' nuclear scientists, Roswell's visitors from outer space, and Santa Fe's artists, and you get an eclectic mix of people, places and experiences that make this state great. Cities in New Mexico are continually ranked among the nation's best places to work and live by Forbes magazine, Kiplinger's Personal Finance, and other corporate and government relocation managers like Worldwide ERC. New Mexico offers endless recreational opportunities to explore, and enjoy an active lifestyle. Venture off the beaten path, challenge your body in the elements, or open yourself up to the expansive sky. From hiking, golfing and biking to skiing, snowboarding and boating, it's all available among our beautiful wonders of the west. AA/EOE/VET/DISABLED. PHS is a drug-free and tobacco-free employer with smoke free campuses.

Keywords: Presbyterian Healthcare Services, Albuquerque , Case Manager, Other , socorro, New Mexico

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