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Heritage Home Health
Employer Name: Heritage Home Health
Employer Address: 4414 Centerview, Ste. 105, San Antonio, TX 78228
Employer Telephone: 210 377-1033
Employer Contact:
Tonya Rose
Heritage Home Health is a growing
Medicare Certified Home Health Agency.
Position Title: RN Case Manager, $3000 SIGN-ON BONUS!
Position Description: An RN Case Manager is responsible for:
Position Requirements:
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Currently licensed RN in Texas.
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Familiarity with Home Health ICD9
coding preferred.
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Home Health experience preferred.
Submit resume to:
Tonya Rose
Posted 3/18/2008 |
University Health System
San Antonio, TX Employer: University
Health System
Employer Location: 4502 Medical Drive San Antonio, Texas 78229
Contact Person:
Celia Govea
Contact Telephone Number: 210-358-4301
Position Title: Nurse Case Manager-Health Plans
Position Description:
Community First Health Plans Inc. is seeking a self-motivated Case
Manager to join Management/Case Management team. The Case Manager is responsible
for planning and evaluating options and services to ensure timely and cost
effective health care for their members.
Position Requirements:
EDUCATION/EXPERIENCE
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BSN preferred.
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Master’s degree is preferred.
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Minimum three years’ acute care experience or
managed care experience is required.
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Minimum one-year of concurrent review
experience is required.
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Must have utilization management/quality
assurance experience.
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Basic knowledge of Medicaid, community
resources and alternate funding programs is desired.
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Knowledge of InterQual screening criteria as
well as DRG, ICD-9 and CPT coding is preferred.
LICENSURE/CERTIFICATION
Submit Resume to:
Website Address:
www.universityhealthsystem.com
Posted 1/24/2008 |
University Health System
San Antonio, TXEmployer: University
Health System
Employer Address: 4502 Medical Drive, San Antonio, TX 78229
Contact Person:
Celia Govea
Contact Telephone Number: 210-358-4103
Position Title: Nurse Case Manager- Hospital Based
Position Description:
The Case Manager is responsible for coordinating with the interdisciplinary
treatment team a plan of care across the health care continuum within a defined
population.
Position Requirements:
EDUCATION/EXPERIENCE
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BSN preferred.
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A minimum of 2 years nursing experience
preferred.
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Work experience in case management, utilization
review or hospital quality assurance is preferred.
LICENSURE/CERTIFICATION
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Current registration with the Texas State Board
of Nurse Examiners is required.
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Case Manager Certification (CCM or ANCC) is
preferred.
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Current American Heart Association, Basic
Cardiac Life Support and Health Care Provider card preferred.
Submit Resume to:
Website Address:
www.universityhealthsystem.com
Posted 1/24/2008 |
TRISUN Healthcare
North Texas RegionEmployer: TRISUN
Healthcare, North, Central & South Texas Region,
Employer Location: North, Central & South Texas Facilities
Position Title: Regional External Case Manager traveling to North,
Central and South Texas region
ABOUT OUR COMPANY: TRISUN
Healthcare is an Austin, Texas-based company that manages skilled nursing homes
and assisted living facilities throughout Texas.
We are looking for an External Case Manager who is willing to travel to
our facilities located in South. Central and North Texas.
Job Summary:
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Responsible for clinical and financial
assessments of patients prior to admission.
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Facilitates interdisciplinary planning and
assists with outcome report completion.
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Provides outcome data to payers and physicians
on an as needed basis.
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Serves as care/cost liaison between patient,
physician, care team members, payer, and discharge planner by coordinating,
monitoring, and communicating patient's progress.
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Assists with coordination to most appropriate
care level.
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Assists sub acute program
director/administrator with census management.
Participates in monthly bill review and A/R management.
Responsibilities:
Role in the Admissions Process-
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Assesses prospective patients to evaluate care
needs and determine suitability for admission.
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Communicates with payers to determine and
verify coverage and adequate funding for required patient services and length
of stay.
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Calculates rate based on patient service needs
and contracts with payer for care delivery.
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Communicates information to care team and
coordinates patient's smooth transition into and through the treatment
process.
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Obtains accurate information from physicians,
patients, family and payers regarding the expected discharge plan, and
communicates this information to the interdisciplinary team.
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Assists the sub acute program
director/administrator with census management.
Internal Responsibilities:
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Ongoing assessment of the patient's clinical
needs and determination of appropriateness for continued stay.
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Objective evaluation of the interdisciplinary
plans, determining barriers, clarifying realistic goals, and identifying
potential alternatives involving physician, team members, patient, and family.
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Initiation and implementation of plan
modifications as necessary through monitoring and re-evaluation to accommodate
changes in treatment or progress.
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Completion of progress reports to payer source
as requested.
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Obtain documentation of patient specific
contract and payer information with generation of confirmation and
verbal/written agreement from the payer source detailing reimbursement rate
and terms
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Coordination and planning of health care
services to promote necessary outcomes and timely discharge.
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Assumption of the role as patient advocate to
assure continuity of care and cost effective quality care with goal oriented
outcomes.
Administrative Responsibilities:
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Provides documentation of contract or payer
information on a timely basis to treatment team and business office and
corporate staff
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Monitors, analyzes, and reports: census and
case study progress data-
Assists business office with accurate billing and timely collection
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Maintains appropriate documentation as
indicated by corporate and facility management.
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Attends regional meetings, scheduled in-service
programs, staff meetings and other center meetings and participation required
committees
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Participates in developing and updating
policies and procedures, and maintains required records and reports
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Coordinates work between departments; maintains
confidentiality of necessary information.
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Thinks and acts logically, rationally, and with
flexibility in order to meet all unusual occurrences of the job/
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Performs any miscellaneous work assignments as
may be required
Referral Development Responsibilities:
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Develops referral sources (physicians, social
workers, hospital discharge planners, insurance companies, managed care case
managers) through outside sales calls with goal of generating increased
managed care census.
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Completes referral development calls to various
other referral sources (civic/professional organizations, home health
agencies, families) in order to identify referral needs and to educate these
referral sources regarding our services.
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Develops and presents CEU in-services to
referral sources to promote familiarity with center and services.
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Arranges on-site tours for referral sources and
family member's
Patient Satisfaction:
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Acts a liaison between payers and decision
makers facilitating a smooth transfer of information
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Assists in program evaluation post discharge.
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Communicates discharge information to physician
and payer with outcome data as appropriate.
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Accompanies patient to physician appointments.
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Assists patient and family with issues of
reimbursement and understanding of policy values.
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Communicate patient and family concerns to sub
acute program director/administrator.
Job Requirements:
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Education:
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Experience:
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Minimum three (3) years clinical experience
and two (2) years experience in medical case management.
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Comprehensive knowledge of workers'
compensation, insurance, and managed care required.
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Ability to negotiate coverage and provide
complete and timely case management reports required.
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Prior experience with an insurance company,
private case management company, or HMO preferred.
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Familiarity with long-term care and/or sub
acute care useful.
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Strong oral and written communication skills
required.
Physical Demands: Work is primarily
sedentary in nature, with exerting up to 10 pounds of force occasionally and/or
a negligible amount of force frequently to lift, carry, push, pull, or otherwise
move objects, including the human body.
Involves sitting, standing, and walking most of the time.
Travel: 50%-75%-
Working Conditions: Primarily inside with well-lit and well-ventilated
areas.
Principal Contacts: Works closely with Regional Director of Operations,
Administrators, sub acute program director, department heads, families,
patients, physicians, discharge planners/social workers, insurance case
managers, and self-insured employers-
General Requirements: Must be capable to execute all terms and conditions
set forth in the HCR Manor Care Employee Handbook, including, but not limited
to:
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Works in a safety conscious manner which
insures that safe work practices are used in order not to pose a risk to self
or others in the workplace
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Complies with company policies and procedures,
and local, state, and federal regulations
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Adheres to policy on Drug Free Workplace
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Interacts in a tactful, diplomatic, and
humanistic manner with residents, families, visitors, and co-workers to
provide a safe, efficient, and therapeutically effective caring environment
which insures the self-respect, personal dignity, rights, and physical safety
of each resident and center guest
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Maintains a dependable attendance record and
adheres to standards of cleanliness, grooming, hygiene, and dress code
Submit resume to:
Cyndi
Matula
Website:
www.trisunhealthcare.com
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