RN Case Manager

United Surgical Partners International Inc (USPI)

San Antonio, TX

JOB DETAILS
SKILLS
Acute Care, Case Management, Clinical Study Publications, Content Management Systems (CMS), Data Collection, Department of National Defence (DND), Diagnosis-Related Group (DRG), Discharge Plans, Disease Investigation, Diversity, Documentation, Equipment Maintenance/Repair, HIPAA (Health Insurance Portability and Accountability Act), Healthcare, Healthcare Quality, Hospital, Infection Control, Maintain Compliance, Medical Office, Medical Records, Microsoft Excel, Microsoft Word, Nursing Credentials, Orthopedics, Outpatient Care, Patient Assessment, Patient Care, Performance Management, Prescription Drugs, Quality Metrics, Quality Monitoring, Quality of Care, Registered Nurse (RN), Regulatory Compliance, Retirement Planning, Surgical Procedures, Time Management, Training/Teaching, Utilization Management
LOCATION
San Antonio, TX
POSTED
11 days ago

USPI South Texas Specialty Hospital is seeking a motivated RN Case Manager to join our team. We have 25 Beds and 8 OR rooms and 3 ER Rooms. We perform outpatient surgical procedures in Orthopedic, Spine.

Job Summary: Facilitates progress through the continuum of care, from Pre-Admission through Discharge for Foundation Surgical Hospital; Provides feedback to payors on patient’s clinical status and secures approvals for additional days of stay; Monitors quality standards as determined by the Performance Improvement Plan and the Medical Staff Quality Indicators; Evaluates patients for discharge planning needs and appropriately directs the patient’s care; Monitors resource consumption for most effective use; Identifies teaching and psychosocial concerns for the best patient outcomes; assists in aggregating data for quality trending; assists in Infection Control surveillance; functions as a Patient Advocate to assist patients in resolving concerns.

Duties and Responsibilities

  • Completes discharge planning assessment within 24 hours of admission
  • Arrange/Coordinate all post-acute care services and equipment in timely manner to provide safe appropriate level of care and supplies upon discharge
  • Compliance with CMS regulations for issuance of IMM, MOON, HINN, DND, ABN, Choice forms and all other discharge planning tasks as assigned
  • Maintain HIPPA compliance
  • Complete and or maintain working knowledge of daily Utilization Review tasks in accordance with hospital policy and InterQual guidelines to include prospective, admission, concurrent, retrospective reviews; correct admission status; avoidable days; medical necessity; continued stay criteria; LOS; Coding and DRG criteria; discharge readiness.
  • Correspondence with interdisciplinary team, physicians, payers, and physician office staff to maintain cost effective and timely coordination of care throughout hospital stay
  • Provide clinical documentation and requested information to payors in accordance with, but not limited to, appropriate admission status, clinical updates, admission/discharge notifications, post-acute care referrals and pre-authorization requests
  • Timely documentation in EHR
  • Serves as a departmental resource for auxiliary departments and staff
  • All other duties as assigned

What We Offer
As an organization, one way we care for our communities and each other is by providing a comprehensive benefits package that includes the following, subject to employment status:

  • Medical, dental, vision, and prescription coverage
  • Life and AD&D coverage
  • Availability of short- and long-term disability
  • Flexible financial benefits including FSAs and HSAs
  • 401(k) and access to retirement planning
  • Paid holidays and vacation

Who We Are
At USPI, we create relationships that create better care. We partner with physicians and healthcare systems to provide first-class ambulatory solutions throughout the United States. We are committed to providing surgical services in the most efficient and clinically excellent manner.

USPI is committed to, and proud of our inclusive culture. An inclusive culture, in our view, is respectful of differences and nurtures and supports the contributions of each individual, while also embracing and leveraging diversity. A diverse workforce, combined with an inclusive culture, makes USPI stronger and better able to meet the needs of our diverse patient and physician population.

#USP-RN

#LI-CM1



Required Skills

Qualifications: 

  • Graduate of an accredited school of nursing, BSN preferred
  • Current, active Texas RN licensure required
  • BLS required
  • One to three years' experience in Case Management
  • Ability to work independently
  • Working knowledge of Microsoft Word and Excel preferred
  • Willingness to learn computer applications necessary for work functions;
  • Ability to adapt to changing situations and various personalities with a positive attitude.
  • Ability to utilize Electronic Heath Care Record for patient documentation.
  • Adheres to strict confidentiality in dealing with patients, families, hospital personnel and the public


Required Experience

About the Company

U

United Surgical Partners International Inc (USPI)

Strength in Numbers
United Surgical Partners International (USPI) and Tenet have combined forces to create the nation’s largest ambulatory surgery provider. Our combined network of exceptional surgical and imaging facilities includes approximately 20 imaging centers, and over 265 short-stay surgical facilities. Together, our partnerships include 50 health systems and more than 4,000 physicians.

Nationwide Experience
Our partners deliver high quality ambulatory solutions in safe, efficient and caring USPI facilities in communities of every size across 29 states. Our physician partners are focused on providing quality patient care, in part because they are invested in their USPI facility. We provide the infrastructure and support they need to perform their best. This is one of the advantages of partnering with USPI.

Quality Patient Services
We share a vision with our physician and health system partners. Our goal is to provide the quality of healthcare services we would insist upon for our own families. Since our founding in 1998, this goal has helped us grow exponentially. Today, our strategic joint venture with Tenet establishes USPI as one of the nation's leading providers of ambulatory solutions.

Operating Excellence
Our size and experience in developing and operating ambulatory facilities and strategic vision allow our facilities to achieve both high patient satisfaction and solid financial results. Moreover, because we engage physicians in the governance and growth of the facility, we also achieve excellent clinical outcomes.

COMPANY SIZE
10,000 employees or more
INDUSTRY
Healthcare Services
FOUNDED
1998
WEBSITE
http://www.uspi.com/