RN - Case Manager (Full Time)

Catholic Health Initiatives Houston, TX
Baylor St. Luke's Medical Center

A quaternary care facility that is home of the Texas Heart® Institute, a world-class cardiovascular research and education institution founded in 1962 by Denton A. Cooley, MD–consistently ranked as one of the nation's best in Cardiovascular Services & Heart Surgery.

The first hospital in Texas and the Southwest designated a Magnet® hospital for Nursing Excellence by the American Nurses Credentialing Center, receiving the award four consecutive times. Baylor St. Luke's is home to three freestanding community emergency centers (Holcombe, Pearland, and San Felipe) offering adult and pediatric care–treating more than 51,000 patients annually. The hospital holds a collaborative partnership with Baylor College of Medicine and affiliations with The University of Texas Medical School at Houston, The University of Texas Medical Branch (Galveston), Houston Baptist University, and Prairie View A&M University.

Position Summary

Coordinates patient care between patients, caregivers, and the multidisciplinary team; collects and evaluates information to facilitate care by assuring that admissions, continued stays, and ancillary services are medically necessary, cost-effective, and providing the appropriate setting to qualify for reimbursement. The case manager intervenes when necessary to assure that case is care is coordinated and timely.

Minimum Qualifications

Education and Licensure: Bachelor's Degree - Nursing OR ADN and 5 years of clinical experience; Registered Nurse (RN) licensure

Minimum Experience: Three (3) years of clinical nursing experience in the acute care or medical setting OR ADN and 5 years of clinical experience

Position Responsibilities

1. Documents on the day of admission, or within the first twenty four hours, a clinical assessment and anticipated discharge plan that addresses use of the full continuum of care

2. Provides plan of care updates to providers inside and outside of the hospital, working with patients and caregivers

3. Continually Assesses and modifies the plan of care based on clinical need and patient preference

4. Manages each patient's plan of care and throughout the stay

5. Leads interdisciplinary rounds to coordinate care with the care team, and to address changes in the discharge plan

6. Consults with appropriate physicians on plan of care and discharge

7. Remains current of Medicare and Medicaid laws and guidelines, Medicare Conditions of Participation, managed care contracts, and other legal and regulatory requirements as they relate to health care case management services. Assures patients are informed of rights and responsibilities as participants in these programs.

Minimum Knowledge, Skills, and Abilities

1. Clinical practice with experience acquired in assigned specialty required

2. Computer skills required; must be able to document in medical records

3. Exercises knowledgeable, independent judgment on routine and non-routine matters

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