DHR Health - US:TX:Edinburg - Days

Summary:

POSITION SUMMARY:

The LVN Case Manager is responsible for facilitating care along a continuum through effective resource coordination to help patients achieve optimal health, access to care and appropriate utilization of resources, balanced with the patient’s resources and right to self-determination.

The individual in this position is responsible for ensuring care is provided at the appropriate level based on medical necessity and assessing the patient for transition needs to promote timely throughput, safe discharge and prevent avoidable readmissions.
This position integrates national standards for case management scope of services including:
Utilization Management supporting medical necessity and denial prevention
Transition Management promoting appropriate length of stay, readmission prevention and patient satisfaction
Care Coordination by demonstrating throughput efficiency while assuring care is the right sequence and at appropriate level of care
Compliance with state and federal regulatory requirements, TJC accreditation standards and DHR policy
Education provided to physicians, patients, families and caregivers

POSITION EDUCATION/ QUALIFICATIONS :

• Graduate from an accredited school of Vocational nursing required

• Licensed Vocational Nurse with the State of Texas is required.

• Current license/valid permit to practice in the State of Texas will be required of all certified individuals.

JOB KNOWLEDGE/EXPERIENCE :

• Three years hospital nursing clinical experience preferred

• Case management experience preferred

Responsibilities:

POSITION RESPONSIBILITES:

The individual’s responsibilities include the following activities:

• Accurate medical necessity screening and submission for Physician Advisor review,

• Care coordination,

• Transition planning assessment and reassessment,

• Implementation or oversight of implementation of the transition plan,

• Leading and facilitating multi-disciplinary patient care conferences,

• Managing concurrent disputes,

• Making appropriate referrals to other departments,

• Communicating with patients and families about the plan of care,

• Collaborating with physicians, office staff and ancillary departments,

• Leading and facilitating discussions regarding ,

• Assuring patient education is completed to support post-acute needs ,

• Timely complete and concise documentation in patient's electronic medical record,

• Maintenance of accurate patient demographic and insurance information,

• Identification and documentation of potentially avoidable days,

• Identification and reporting over and underutilization,

• And other duties as assigned

Other information:

LINES OF REPSONSIBILITES :

(Chain-of-command)

1. Case Management Supervisor 2. Director of Resource Management

CUSTOMER SERVICE:

Provide excellent customer service to all DHR customers. All employees are required to attend the DHR C.A.R.E.S program which outlines the Customer Service Principals including: Commitment, Accountability, Respect, Excellence and Service.

AGE SPECIFIC :

Employees must be able to demonstrate the knowledge and skills necessary to provide care appropriate to the age of the patients served in his/her assigned unit. The individual must demonstrate knowledge of principles of growth and development over the life span and possess the ability to assess data reflective of the patient’s status and interpret the appropriate information needed to identify each patient’s requirement relative to his or her age.

AMERICANS WITH DISABILITIES ACT: (ADA) :

A. Essential Duties : Indicated by bold print within performance standards, preceding individual numbered criteria.

The following table provides physical requirements that will be associated with, but not limited to, this position:

B. Working Conditions : The individual spends over 95% of his/her time in an air-conditioned environment with varying exposures to noise. There is protection from weather conditions but not necessarily from temperature changes. The position does have low exposure to malodorous, infectious body fluids from patients and some minimal exposure to noxious smells from cleansing agents.

C. Occupational Exposure: This position has minimal to no exposure to blood, body fluids, or tissues and is an OSHA Category III (although situations can be imagined or hypothesized under which anyone, anywhere, might encounter potential exposure to body fluids). Person who performs these duties are not called upon as part of their employment to perform or assist in emergency medical care or first aid or to be potentially exposed in some other way.

D. Aptitudes : HIGH 1 2 3 4 5 6 LOW

Intelligence: General learning ability: The ability to “catch on” or understand instructions and underlying principles. Ability to reason and make judgments. 3

Verbal: Ability to understand meanings of words and ideas associated with them, and to use them effectively. To comprehend language, to understand relationships between words, and to understand meanings of whole sentences and paragraphs. To present information or ideas clearly. 3

Numerical: Ability to perform arithmetic operations quickly and accurately. 2

Spatial: Ability to comprehend forms in space and understands relationships of plane and solid objects. Frequently described as the ability to “visualize” objects or two or three dimensions, or to think visually of geometric forms. 2

Form Perception: Ability to perceive pertinent details and objects or in pictorial or graphic material to make visual comparisons and discriminations and see slight differences in shapes and shadings of figures and widths and lengths of lines. 3

Clerical Perception: Ability to receive pertinent details and verbal or tabular material. To observe differences in copy, to proofread words and numbers, and to avoid perceptual errors in arithmetic computation. 2

Motor Coordination: Ability to coordinate eyes and hands to fingers rapidly and accurately in making precise movements with speed. Ability to make a movement response accurately and quickly. 3

Finger Dexterity: Ability to move hands easily and skillfully. To work with fingers in placing and turning motions. 3

Manual Dexterity: Ability to move hands easily and skillfully. To work with hands in placing and turning motions. 3

Eye-Hand-Foot Coordination: Ability to move the hand and foot coordinately with each other in accordance with visual stimuli. 3

Color Discrimination: Ability to perceive and respond to similarities or differences in colors, shapes, or other values of the same or different color. To identify a particular color, or to recognize harmonious or contrasting color combinations, or to match color adequately. 3

I have read and reviewed my job description with my supervisor or designee and I understand the job I am expected to perform.

If applicable ____________ certification will be completed within _________ time frame of hire/transfer date.

Employee Signature: ________________________________ Date: ____________________

Transfer/Hire Date Effective: ________________________.