The individual in this position is responsible to facilitate care along a continuum through effective resource coordination to help patients achieve optimal health, access to care and appropriate utilization of resources, balanced with the patientâ��s resources and right to self-determination. The individual in this position has overall responsibility to ensure that care is provided at the appropriate level of care based on medical necessity and assess the patient for transition needs to promote timely throughput, safe discharge and prevent avoidable readmissions. This position integrates national standards for case management scope of services including:
â· Utilization Management supporting medical necessity and denial prevention
â· Transition Management promoting appropriate length of stay, readmission prevention and patient satisfaction
â· Care Coordination by demonstrating efficient throughput while assuring care is sequenced and at the appropriate level of care
â· Compliance with state and federal regulatory requirements, TJC accreditation standards and Tenet policy
â· Education provided to physicians, patients, families and caregivers
â· Provides educational programs for Case Management Department on community resources use in discharge planning
â· Provides reports to Director of Case Management (DCM) and hospital leadership as requested
â· Provides management of the department, but not limited to, hiring/training/managing staff, schedule coordination, analysis and reporting, interfacing, collaborating and working closely with the other departments.
The individualâ��s responsibilities include the following activities: a) assist the DCM in the daily operations of the department b) transition planning assessment and reassessment, d) implementation or oversight of implementation of the transition plan, e) leading and facilitating multi-disciplinary patient care conferences, f) managing concurrent disputes, g) making appropriate referrals to other departments, h) identification and reporting over and underutilization, i) communicating with patients and families about the plan of care, j) collaborating with physicians, office staff and ancillary departments, k) leading and facilitating Complex Case Review, l) assuring patient education is completed to support post-acute needs , m) timely complete and concise documentation in Tenet Case Management documentation system, n ) maintenance of accurate patient demographic and insurance information, o) identification and documentation of potentially avoidable days, p) and other duties as assigned.
The requirements listed below are representative of the knowledge, skill, and/or ability required. In accordance with The Americans with Disabilities Act (ADA), it is possible that requirements may be modified to reasonably accommodate disabled individuals. However, no accommodations will be made which may pose serious health or safety risks to the employee or others or which impose undue hardships on the organization.
Minimum Education: BSN preferred.
Minimum Experience: Minimum of two years acute hospital experience preferred. Required skills include demonstrated organizational skills, excellent verbal and written communication skills, ability to lead and coordinate activities of a diverse group of people in a fast paced environment, critical thinking and problem solving skills and computer literacy.
Required Certifications/Registrations/Licenses: A valid Permanent Multi-State RN License from the state in which you reside is required. Should you hold a RN license from another Compact state, you are required to apply for and obtain a Multi-State RN License from the state in which you reside within 30 days. American Heart Association BLS CPR Required.
Supervisory Responsibilities: Yes
Job: Managers and Directors
Primary Location: Rock Hill, South Carolina
Facility: Piedmont Medical Center
Job Type: Full-time
Shift Type: Days
Employment practices will not be influenced or affected by an applicantâ��s or employeeâ��s race, color, religion, sex (including pregnancy), national origin, age, disability, genetic information, sexual orientation, gender identity or expression, veteran status or any other legally protected status. Tenet will make reasonable accommodations for qualified individuals with disabilities unless doing so would result in an undue hardship.
Internal Number: 2105014601
About Piedmont Medical Center
Tenet Healthcare Corporation (NYSE: THC) is a diversified healthcare services company headquartered in Dallas with 112,000 employees. Through an expansive care network that includes United Surgical Partners International, we operate 65 hospitals and approximately 510 other healthcare facilities, including surgical hospitals, ambulatory surgery centers, urgent care and imaging centers and other care sites and clinics. We also operate Conifer Health Solutions, which provides revenue cycle management and value-based care services to hospitals, health systems, physician practices, employers and other clients. Across the Tenet enterprise, we are united by our mission to deliver quality, compassionate care in the communities we serve.