We are Emerus, the leader in small-format hospitals. We partner with respected and like-minded health systems who share our mission: To provide the care patients need, in the neighborhoods they live, by teams they trust. Our growing number of amazing partners includes Allegheny Health Network, Ascension, Baptist Health System, Baylor Scott & White Health, ChristianaCare, Dignity Health St. Rose Dominican, The Hospitals of Providence, INTEGRIS Health, MultiCare and WellSpan. Our innovative hospitals are fully accredited and provide highly individualized care. Emerus' commitment to patient care extends far beyond the confines of societal norms. We believe that every individual who walks through our doors deserves compassionate, comprehensive care, regardless of their background, identity, or circumstances. We are committed to fostering a work environment focused on teamwork that celebrates diversity, promotes equity and ensures equal access to information, development and opportunity for all of our Healthcare Pros.
Position OverviewThe purpose of this position is to provide ongoing support and expertise through comprehensive assessment, planning, implementation and overall evaluation of individual patient needs. The goal of the position is to enhance the quality of patient care through innovative and cost-effective best practices. This position promotes the integration of case management, utilization review, discharge planning, denial management and patient transfer management to ensure successful continuity care.
Essential Job Functions Ensure patient progression through continuum of careEnsure compliance during all admission and transfer processesDocument patient outcomes during and after each coordination of careMaintain patient health information privacy at all timesCoordinate transfer center admission and/or transfer requests as requiredCoordinate and complete daily patient continuum reports as requiredComplete and ensure Utilization Review of all admissionsMaintain regulatory compliance with CMS Conditions of ParticipationRecord and report extended delays in careCoordinate discharge planningMonitor and update discharge planning resourcesPerform denial management responsibilitiesCoordinate payer communicationAct as a patient advocate: investigate and report adverse occurrences and perform staff education related to resource utilization, discharge planning and all other pertinent aspects of healthcare deliveryCollaborate with clinical staff in development and execution of the plan of care and achievement of goalsMinimal travel may be requiredPerform other duties as assigned Basic Qualifications RN licensed to practice in the State of Texas, required2 years hospital clinical experience, requiredBachelor’s Degree, strongly preferredUtilization Review/Case Management experience, preferredActive Case Management Certification or other professional RN Certification, preferredInterQual and/or Milliman experience, preferredSuperior interpersonal skillsAbility to establish and maintain collaborative, effective working relationshipsAbility to communicate professionally and effectively in oral, written and electronic formatsDemonstrate analytical and critical thinking abilities with proactive decision-making and negotiating skillsDemonstrate professional organizational skillsAbility to manage multiple tasks simultaneouslyPosition requires fluency in English; written and oral communication Options Apply for this job onlineApplyShareRefer this job to a friendRefer Sorry the Share function is not working properly at this moment. Please refresh the page and try again later. Share on your newsfeed Need help finding the right job? We can recommend jobs specifically for you! Click here to get started. Application FAQsSoftware Powered by iCIMS
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