Hospital Case Manager
On-siteSan Antonio, Texas, United States
Job Summary
Round daily on assigned GMG MC patients in the hospital setting and weekly on those in the SNF setting to monitor admissions for medical appropriateness. Assess medical, physical, psycho-social, and transition needs to anticipate services and follow-up care, then confer with physicians, patients, and families to develop discharge plans. Enter timely and accurate information into the EMR to document communications, referrals, and plans while collaborating with the CM team on coverage determinations and authorizations. Perform clinical high-risk home visits as assigned and attend the weekly Patient Care Committee to optimize care protocols. Maintain current knowledge of health plan benefits and preferred provider networks to guide physicians on contracts and facilities.
Required Qualifications
- Active, unencumbered Registered Nurse with an associate degree
- State-licensed practical nurse
- BS in nursing
- CPR certification with AED
- 3-5 years RN experience
- 4+ years of diverse clinical experience in caring for acutely ill patients with multiple disease conditions in adult and geriatric populations
- Current valid Texas Driver License
- Proof of current insurance
- Manual dexterity
- Ability to sit
- Ability to stand
- Ability to stoop
- Ability to reach
- Ability to kneel
- Ability to crouch
- Ability to bend
- Ability to walk
- Ability to lift up to 40 lbs without assistance
- Close vision and ability to adjust focus
- Ability to work efficiently under pressure
- Skilled in use of computer/EMR systems
- Knowledge of Word processing software
- Knowledge of spreadsheet software
- Knowledge of Internet
- Knowledge of database software
- Must be able to lift 40 lbs
- Must be able to work efficiently under pressure
Desired Qualifications
- Bilingual English/ Spanish fluency
- Case Management Certification (CCM)
- BS in nursing preferred
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