RN-E D Case Manager (Evenings 3p-11p) Job in Odessa 79760, Texas Us
The ED Case Manager will assume primary responsibility of cases for documentation of appropriate medical necessity for the inpatient or observation status. Communicates with physician, ancillary staff, and payers and assists in arranging transfers or alternate placement when indicated. Assures proper level of care assignment. Facilitates with ED Case Managers and other allied health professionals to promote and ensure that quality care is provided and outcomes are achieved in a timely and cost-effective manner. Utilizes a complete and systematic methodology /process to assess, plan, implement, evaluate and provide patient care coordination for patients from pre-hospital through post-hospital aftercare. Assists in the development of physician profiles to identify over/under utilization patterns. Promotes appropriate post-hospital utilization of resources, adequate education of patient and hospital staff, and decreased incidence of re-admissions. Supports hospital goals and objectives in compliance with regulatory guidelines. The ED Case Manager will work in collaboration with all healthcare disciplines to assure a continuum of appropriate and timely services.
Ability to work competently with computer based charting and other clinical and non-clinical software programs, Adaptability to change, good organizational skills, read and communicate effectively in English, working knowledge of criteria and understand insurance companies and coverage details. Working knowledge of Medicare, Medicaid and managed care utilization review requirements. Ability to advocate for patient's, operate office equipment. Critical thinking skills. Effectively interact with insurance companies and communities healthcare recourses. Utilizes independent judgment and discretion, in addition to consideration of standards outlined by Milliman and Interqual. Identifies and plans strategies to reduce readmissions, identify PCP program and resource consumption.
Founded in 1998, privately-held IASIS Healthcare is a leading owner and operator of community-focused hospitals in high-growth markets. IASIS Healthcare began principal operations in October of 1999, in transactions arranged by the management team and Joseph Littlejohn Levy. In 2004, Texas Pacific Group, a private equity firm managing over $13 billion in assets, led a group of investors to acquire IASIS. Today, TPG is the single largest stockholder in IASIS.
IASIS Healthcare is dedicated to providing high-quality, cost-effective healthcare. Fundamental to the company's business strategy is the development of strong relationships and partnerships with physicians, employees, and payors. Together, the people of IASIS Healthcare share a common vision of quality care, customer service, an appropriate mix of services, cost control, and capital investments designed to meet the healthcare needs of the communities served by IASIS hospitals.