The Case Management Coordinator is responsible to conduct medical necessity screening and work collaboratively with the interdisciplinary team to provide care coordination for patients under the direction of a Registered Nurse and in compliance with evidence-based practice and regulatory requirements. The Case Management Coordinator complies with the scope of services defined by the Licensed Vocational /Practical Nurse LVN/LPN state licensure requirements. The Case Management Coordinator integrates national standards for case management scope of services including: Utilization Management supporting medical necessity and denial prevention. Transition Management promoting appropriate length of stay, readmission prevention and patient satisfaction. Care Coordination by demonstrating throughput efficiency while assuring care is the right sequence and at appropriate level of care. Compliance with state and federal regulatory requirements, TJC accreditation standards and Tenet policy. Education provided to physicians, patients, families and caregivers.
The Case Management Coordinator's responsibilities include the following activities:
Accurate medical necessity screening and submission for Physician Advisor review
Implementation of the transition plan based on RN Case Manager and/or Social Worker (SW) assessment(s)
Communication with interdisciplinary team during patient care conferences
Management of concurrent disputes
Communication with patients and families regarding the plan of care established by RN, SW and Physician
Collaboration with physicians, office staff and ancillary departments
Clear, complete and concise documentation in electronic system
Maintenance of accurate patient demographic and insurance information
Identification and documentation of potentially avoidable days
Identification and reporting of over and underutilization
And other duties as assigned
Required: 2 years patient care experience
Required: The Case Management Coordinator must be currently licensed, certified or registered to practice profession as required by law, regulation in state of practice or policy.
Job: Case Management/Home Health
Primary Location: San Antonio, Texas
Facility: Baptist Health System
Job Type: PT2Y
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: 2105010822
About Baptist Health System
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.