Registered Nurse Case Manager

Registered Nurse Case Manager at Baylor Scott & White Medical Center - Trophy Club

Baylor Scott & White Medical Center - Trophy Club is hiring a Registered Nurse Case Manager to join our team! This position is for a PRN Day Shift.

Welcome to Baylor Scott & White Medical Center - Trophy Club, TX, where we are dedicated to providing the pinnacle of excellence you've come to expect from Baylor – right within your own community! Why Choose Baylor Scott & White Medical Center - Trophy Club?

• A Commitment to Excellence: Join a team devoted to delivering top-tier clinical care and an outstanding patient experience, all within your local reach. Our commitment to excellence is palpable in every facet of your journey.
• Diverse Specializations: Our specialties range from Bariatrics to Urology, catering to a wide spectrum of medical needs. We currently have 9 Operating Room, Bariatric Center of Excellence and are Total Joint Accredited. Whether it's a specialized procedure or general care, you'll play an essential role in our commitment to patient well-being.
• 24/7 Emergency Care: Our 24-hour emergency department is always primed to handle unexpected pain or injuries, providing timely care when it's needed most.
• Cutting-Edge Facilities: Our six advanced operating rooms enable our physicians to deliver the highest standard of surgical care. Extensive onsite diagnostic imaging expedites treatment and enhances patient care.
• USPI Partnership: Baylor Scott & White Medical Center - Trophy Club stands as a testament to collaborative excellence, as a partnership between Baylor Scott & White and USPI. This synergy fosters a culture of innovation, learning, and collective growth.
• Committed Patient Care: Just as we would for our own families, we are unwavering in our commitment to providing quality, specialized treatment with compassion tailored to each individual under our care.

Join us at Baylor Scott & White Medical Center - Trophy Club and embark on a career journey that marries professional growth with impactful patient care. Apply today to be part of our dynamic team, where your dedication and expertise create an environment dedicated to exceptional service. Your path to a rewarding career starts here!

The Case Manager will be responsible for coordinating patient care throughout the continuum of care using approved criteria to determine patients' criteria for the ordered level of care and status on admission. This job description incorporates the Standards of Practice and guiding principles from the Case Management Society of America. The CM performs ongoing continued stay reviews and appropriately reports reviews to insurance carriers as required for certification. Works with physicians and other practitioners to change admission status or level of care as needed and as allowed by law and educates medical staff on care coordination activities and needs. Manages the utilization of resources and reports issues and findings to the Utilization Review Committee for improvement referring outliers to peer review. Reviews medical records for ongoing InterQual/Milliman compliance, quality improvement, and utilization review per CMS guidelines and hospital policy. Performs reviews and data collection and other functions under the direction of the CQO. The CM begins discharge planning on admission and follows the patient through discharge making appropriate discharge post-acute care arrangements. All program activities will be in accordance with Joint Commission, CMS and all other applicable federal, state and local guidelines.

Qualifications

Education:

• Graduate of an accredited school RN, LVN, or Social Services

Licensure/Certification:

• Current Texas License
• CCM certification preferred

Required Experience:

• Minimum 1-year experience in a hospital setting in quality management, case management and/or utilization review preferred.
• Good communication and leadership skills
• Excellent organizational skills; computer training (Excel)
• Strong knowledge base relative to surgical procedures.
• Demonstrates knowledge of Joint Commission/CMS standards including medical record documentation
• Excellent teaching skills, detail oriented, and ability to lead meetings required
• Working knowledge of InterQual/Miliman criteria

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:

• 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.