This position will provide case management oversight for all CHRISTUS Spohn Hospital Case Management activities. Consistency in model and outcomes using as appropriate leading practices, evidenced based models and changing compliance and regulatory requirements will be influenced throughout the Spohn system. The incumbent will support a responsive case management model that includes, but is not limited to: case management assessment, care coordination, discharge planning assessment and facilitation, contractual and compliance requirements of third party payors, provide support and insight regarding evidence based practice and efficient and effective use of resources to provide best possible patient outcomes, support and affect as appropriate patient safety, quality management and process improvement efforts. Direct, plan and coordinate all inpatient hospital utilization review and case management activities with on-site utilization management and case management development and implementation of utilization management processes. The incumbent will also provide administrative leadership to the Director of Patient Placement to achieve successful and efficient patient flow and throughput. The incumbent is expected to work closely with all internal functional departments, representatives of third party payors and community agencies to provide quality patient outcomes while managing medical resources effectively.
Master's degree required.
Demonstrate thorough understanding of length of stay and opportunity index goals.
Maintain federal and state knowledge of case management compliance and articles of participation.
Thorough knowledge of managed care utilization and quality management activities and requirements.
Understands financial impact of efficient resource management.
Ability to hire, train and coach employees.
Demonstrate understanding of competency-based criteria for case management.
Ability to manage a complex, multiple hospital case management program.
5-7 years experience of successful management experience and in-depth understanding of managed care, experience in budgeting and strategic planning of goals and objectives, experience in statistical analysis and construction of reporting system.
Experience managing a variety of case management models using an interdisciplinary team approach.
Health System experience is helpful
Current Texas RN license is required.
National certification in related field required (case management, coding, or risk management).
Our Mission: WHY WE EXIST. To extend the healing ministry of Jesus Christ. Our Core Values: WHAT WE BELIEVE IN.DIGNITY Respect for the worth of every person, recognition and commitment to the value of diverse individuals and perspectives, and special concern for the poor and underserved. INTEGRITY Honesty, justice, and consistency in all relationships. EXCELLENCE High standards of service and per...formance. COMPASSION Service in a spirit of empathy, love, and concern. STEWARDSHIP Wise and just use of talents and resources in a collaborative manner.Our Vision: WHAT WE ARE STRIVING TO DO. CHRISTUS HEALTH, a Catholic health ministry, will be a leader, a partner and an advocate in the creation of innovative health and wellness solutions that improve the lives of individuals and communities so that all may experience God's healing presence and love. Our Name and Symbol:WHO WE ARE. CHRISTUS is Latin for "Christ," and proclaims publicly the core of our mission. OUR NAME choice also recognizes the heritage of our two congregational sponsors, the Sisters of Charity of the Incarnate Word in Houston and San Antonio. Jesus Christ is the Incarnate Word, the Word of God made flesh. It is, therefore, only fitting that it is in another form of His name that our health ministries are called together. OUR SYMBOL Reflects the healing ministry of Jesus Christ - a combination of a medical cross and a religious cross. The flowing banner on the cross is a common symbol of the risen Christ, while the royal purple signifies Christ. The flowing banner also conveys a sense of motion as we move forward into a new era of service to our communities.