Location: Hope,NM, USA
Department: OP Care Management Svcs FTE: 1.00 Full Time Shift: Days Position Summary: Under the supervision of department Director or designee, assist in providing case management services; assist in some aspects of the admissions and discharge process to facilitate smooth and timely admission and discharge and appropriate referral to available resources. Ensure adherence to Hospitals and departmental policies and procedures. Patient care assignment may include neonate, pediatric, adolescent, adult and geriatric age groups. Detailed responsibilities: ARRANGEMENTS - Arrange meals, lodging and transportation for families as requested COORDINATION - Assist in coordinating medical equipment and supplies for home use, communicating with appropriate members of treatment team, family and patient as directed COORDINATION - Assist in making arrangements for home health services as directed COMMUNICATION - Communicate plans for equipment, transportation, referrals, etc., as appropriate, to members of the treatment team; perform follow-up communication with patients or appropriate designee as needed COMMUNICATION - Communicate with appropriate staff, patients or designees and outside agencies regarding any necessary financial information, as directed TRANSFER - Assist with coordinating transfer of patients to appropriate settings, i.e., acute care, psychiatric inpatient, skilled nursing facility, or other destinations CONFERENCES - Coordinate patient care conferences, as requested COMMUNICATION - Participate in patient care team meetings to review follow-up actions and patient discharge planning CORRESPONDENCE - Formulate, copy, fax and distribute correspondence and medical records, as directed DATA - Collect and enter required data; prepare reports as directed INQUIRIES - Answer phones, obtain appropriate information, respond to requests and transfer calls; retrieve messages, take information and route, as appropriate PATIENT ASSISTANCE - Assist patient or designee in completing patient assistance forms/documentation, and maintain records PRIOR AUTHORIZATION - Verify coverage eligibility on patients for outside services as needed FINANCIAL ASSISTANCE - Coordinate and obtain missing information related to denials due to the lack of notification authorization RECORDS - Establish, maintain, process, and update files, records, and/or other documents REFERRALS - Maintain resources and reference materials; direct referrals to community agencies, as needed DEVELOPMENT - Enhance professional growth and development through participation in educational programs, reading current literature, attending in-services, meetings and workshops PATIENT SAFETY 1 - Follow patient safety-related policies, procedures and protocols PATIENT SAFETY 2 - Demonstrate proactive approach to patient safety by seeking opportunities to improve patient safety through questioning of current policies and processes PATIENT SAFETY 3 - Identify and report/correct environmental conditions and/or situations that may put a patient at undue risk PATIENT SAFETY 4 - Report potential or actual patient safety concerns, medical errors and/or near misses in a timely manner PATIENT SAFETY 5 - Encourage patients to actively participate in their own care by asking questions and reporting treatment or situations that they don't understand or may not seem right Qualifications Education: Essential: High School or GED Equivalent Nonessential: Associate Degree Bachelor's Degree Education specialization: Nonessential: Related Discipline Related Discipline Experience: Essential: No minimum experience required Nonessential: Medical terminology knowledgeBilingual English, Spanish, Keres, Tewa, Tiwa, Towa, Zuni, or NavajoBilingual English/VietnameseCase management experienceUtilization management experience2 years directly related experience Credentials: Essential: Not Applicable/Not Required CPR for Healthcare/BLS Prov or Prof Rescuers w/in 30 days Physical Conditions: Light Work: Exerting up to 20 pounds of force occasionally, and/or up to 10 pounds of force frequently, and/or a negligible amount of force constantly (Constantly: activity or condition exists 2/3 or more of the time) to move objects. Physical demand requirements are in excess of those for Sedentary Work. May require walking or standing to a significant degree or requires sitting most of the time but entails pushing and/or pulling of arm or leg controls; and/or may require working at a production rate pace entailing the constant pushing and/or pulling of materials even though the weight of materials is negligible. Working conditions: Essential: Minor Hazard - physical risks, dirt, dust, fumes, noise