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Travel Nurse RN - Case Manager - $1,886 per week in San Antonio, TX

TravelNurseSource

San Antonio, TX

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JOB DETAILS
SALARY
$1,886–$1,886
SKILLS
Analysis Skills, CPR Certification, Case Management, Certified Case Manager (CCM), Clinical Outcomes, Clinical Study Publications, Cost Effectiveness Analysis, Customer Relations, Delivery Management, Discharge Plans, English Language, Healthcare, Leadership, MEDITECH, Managed Care, Microsoft Windows Operating System, Multilingual, Nursing, Nursing Credentials, Patient Assessment, Patient Care, Patient Care Denials, Performance Analysis, Process Improvement, Quality Management, Quality of Care, Registered Nurse (RN), Regulations, Reimbursement, Reporting Skills, Resource Management, Safety Process, Social Work, Spanish Language, Standards of Care, Team Player, Time Management, Trend Analysis, Variance Analysis, Word Processing
LOCATION
San Antonio, TX
POSTED
1 day ago
TravelNurseSource is working with Cynet Health to find a qualified Case Manager RN in San Antonio, Texas, 78207!

Job Title: Care Manager Profession: RN Specialty: Case Management Duration: 13 weeks Shift: Day Hours per Shift: 8 Experience: Minimum of 5 years in clinical practice for the population to be served License: Currently licensed as RN in the State of Texas required Certifications: CPR preferred, Certification in Case Management preferred Must-Have: Graduate of an accredited school of Nursing required BSN preferred Proficient word processing skills in a Windows environment required Ability to analyze and create reports and presentations via software applications Familiarity with MIDAS and Meditech systems preferred Bilingual (English/Spanish) preferred Case Management/Resource Management and discharge planning experience preferred Milliman (MCG) Guideline and Interqual criteria experience highly preferred Description: This position provides expertise and leadership to ensure effective resource management for patient care delivery. Case Managers enhance the continuity of care and cost effectiveness by integrating the functions of case management, resource management, clinical documentation management, and discharge planning. Daily and concurrently involved in the management of inpatient and observation patients through comprehensive assessment, planning, interventions, and evaluations of appropriate level of care. Collaborates with other members of the healthcare team to ensure the above according to the mission of the organization. Key driver of throughput process by safe discharge planning. Daily monitors length of stay compared to general managed length of stay on each patient to reduce opportunity days to reach ratio. Impacts managed care general length of stay by managing per guidelines. Assesses assigned patient population for medical necessity, level of care, and appropriateness of setting and services. Utilizes guidelines to track impact and variance. Collaborates with social worker to proactively arrange to meet facilities' target discharge time. Initiates participant referrals and proactively uses reports to track patient progress. Communicates and collaborates with nursing, physicians, and other healthcare professionals daily related to length of stay. Documents delays of care and readmissions appropriately and timely to develop potential trends and improved interventions. Reconciles services available and rendered with patient benefit allowances to assure reimbursement and minimize financial losses for patients and the facility. Proactively refers cases for medical necessity review and denial avoidance. Demonstrates and maintains current knowledge of regulatory agencies relevant to work processes for compliance. Attends and actively participates in interdisciplinary patient care rounds on a daily basis and works with the healthcare team to collaboratively formulate appropriate and realistic discharge plans. Demonstrates positive role modeling of customer relations. Uses appropriate communication techniques. Identifies and assists outcomes management processes by reporting variances in standards of care for identified patient populations. Acts as a catalyst for change in the organization; demonstrates the ability to adapt to overcome resistance and inertia. Devises systems and processes which improve the overall functioning of the organization. Demonstrates the confidence and drive to face and overcome challenges to achieve organizational goals. Works to improve healthcare processing in general and implements strategies aimed at improving clinical outcomes. Utilizes licensed evidence-based tools to analyze and identify trends or patterns of performance through variance reporting to improve quality, satisfaction, and decrease cost variation. Appropriately adapts assigned assessment, treatment, and/or service methods to accommodate the unique needs of each member served. Demonstrates adherence to core values of the organization. Some weekend work and work after normal business hours may be required as needed to meet the needs of the facility and patients. Performs other duties as directed.

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TravelNurseSource