Case Manager Associate - LVN at Methodist Hospital in San Antonio, Texas

Job Description:

DESCRIPTION SHIFT: Days (rotating weekends)

SCHEDULE: Full-time

Do you have a passion for healthcare and helping others? Do you enjoy working in a fast-paced, patient-centered environment? Jump-start your career in our CASE MANAGEMENT department. Submit your application today!

BENEFITS:

We offer you an excellent total compensation package, including competitive salary, excellent benefit package and growth opportunities. We believe in our team and your ability to do excellent work with us. Your benefits include 401k, PTO medical, dental, flex spending, life, disability, tuition reimbursement, employee discount program and employee stock purchase program. We would love to talk to you about this fantastic opportunity.

Seeking a FT - Day shift LVN CASE MANAGEMENT ASSOCIATE to join our team who under the direction of the case management director, will be responsible for the securing the initial insurance authorization of the hospital stay and/or the implementation of the established discharge plan. They support throughput by communicating statuses of post-acute services and/authorizations to the Case Manager or Social Worker. The Case Manager can then evaluate and modify the treatment plan to achieve optimal patient discharges. Their function emphasizes patient and family satisfaction while balancing the efficacious use of resources.

WHAT YOU WILL DO IN THIS ROLE:

DISCHARGE PLANNING- INITIAL PLAN IS DEVELOPED BY THE RN CASE MANAGER OR MSW SOCIAL WORKER

* Collects information to facilitate assessment of insurance or financial coverage for post-acute resources. Contacts identified agencies to make arrangements for the procurement and delivery of post-acute required services. Ensures all discharge plans are followed through to resolution or informs the Case Manager if the identified plan cannot be followed.

* Completes all necessary paperwork for coordination of post-acute care including patient choice. Utilizes the case management software for communication with vendors.

* Communicates any changes or updates to the discharge plan with the patient and/or family and the healthcare team.

* Appropriately documents any interaction with the patient and/or family or the healthcare team discussions regarding changes to the established discharge plan, including Avoidable Days if the patient stays past his/her discharge date.

UTILIZATION MANAGEMENT

* Facilitates timely transmission of admission, concurrent and retrospective utilization review information with third party administrators. Communicates pertinent information from payors to Case Managers. Documents authorization or denial information in the case management system.

* Proficient in standard screening criterion (i.e. InterQual) to perform initial and concurrent reviews.

* Submits clinical information to the insurers in accordance with their specific requirements.

* Initiates peer to peer with attending physician or other appropriate physician with the Insurance Medical Director. Documents outcomes in the case management system.

* Escalates issues to the Case Management Director to intervene if unusual insurance practices are demonstrated.

* Documents Denied Days in the appropriate case management system.

QUALIFICATIONS

EDUCATION:

* Graduate of an accredited LVN nursing program

EXPERIENCE:

* Recent two year's experience in a Skilled Nursing Facility, Inpatient Long-Term or Acute Care Hospital.

LICENSE AND CERTIFICATION:

*

Maintenance of current Texas LVN license

PREFERRED:

* Previous case management experience

* Bachelor of Science in Nursing

Be a part of an organization that invests in you. We are actively reviewing applications. Qualified candidates will be promptly contacted by our hiring managers for interviews. Submit your application today and help us raise the bar in patient care!

Methodist Hospital opened in 1963 as the first hospital in the now internationally acclaimed South Texas Medical Center. With over 800 beds, Methodist Hospital offers a broad range of specialties including cardiology, oncology, bone marrow transplants, emergency medicine, neurosciences, maternity care, gynecology and orthopedics. We are proud to be the largest provider of the lifesaving ECMO Program in San Antonio, are home to the largest robotics program in the world, and our Adult Blood Cancer and Stem Cell Transplant unit has become the first program to receive FACT Accreditation in North America.

As the flagship hospital, and most comprehensive medical care facility of Methodist Healthcare, we appreciate the support and recognition we receive from the community. We've recently been named the No.1 Best Regional Hospital by the U.S. News and World Report for 2019-20. We pride ourselves on providing the highest quality of care possible for our patients, which is proven by our consecutive Grade A Leapfrog Hospital Safety scores. In addition, Methodist Hospital not only received a Primary Stroke Center designation from The Joint Commission, but has also received a Comprehensive Stroke Center Certification from DNV GL Healthcare, designating the facility as offering the most advanced stroke treatment available in a given geographic area. For more information, please visit our website at www.sahealth.com and select Methodist Hospital under Locations.

We are an equal opportunity employer and value diversity at our company. We do not discriminate on the basis of race, religion, color, national origin, gender, sexual orientation, age, marital status, veteran status, or disability status.

NOTICE

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