Job Description

Job Description

Description
Case Management Analyst - Texas Health Mansfield- operated as joint venture between Texas Health Resources and AdventHealth

Location: 2300 Lone Star Road; Mansfield, TX

Top Reasons to Work at Texas Health Mansfield; Mansfield, TX

* Join a family of caregivers focused on whole-person health and committed to making communities healthier.
* Provide wholistic care for patients that extends to the spiritual level by praying with patients and families. Chaplains are available to meet with patients, families and team members 24 hours a day, 7 days a week to provide spiritual support.
* Help develop a brand new $150 million community hospital and medical office building that will provide services such as Medical/Surgical, ICU, Womens Services, General Surgery, Orthopedics, Interventional Cardiology and Gastroenterology.
* Grow in your career with AdventHealth, named in 2018 by Beckers Hospital Review as one of the 150 Top Places to Work in Healthcare. AdventHealth has partnered with Texas Health Resources, named in 2019 as one of Fortunes 100 Best Companies to Work For, to build Texas Health Mansfield, which is creating new opportunities for employment and professional growth.
* Thrive in the Mansfield community, ranked by CNN/Money Magazine as 17 for Best Places to Live. Mansfield is one of the fastest growing areas of North Texas, projected to reach more than 250,000 residents by 2023. Future job growth over the next ten years is predicted to be 41%, higher than the national average of 33.5%. Mansfield has top-rated schools, over 900 acres of parkland, quality housing, a historic downtown area, recreational opportunities for all ages, and a growing business community.

Work Hours/Shift:

Full Time - Days

You Will Be Responsible For:

* Performs concurrent patient reviews related to appropriateness, level of care, diagnostics and procedures performed.
* Applies appropriate screening criteria(s) in a timely manner to determined initial admission and continued stay necessity.
* Initiates appropriate activities when patients do not meet criteria or when alternative care is needed.
* Communicates findings to insurance companies in a timely and accurate manner.
* Determines appropriate admission status and communicates with appropriate individuals.
* Reviews case for appropriate documentation which supports the patients intensity of service and severity of illness.
* Performs quality indicators reviews. Screens cases for required monitors.
* Identifies clinical risk issues and reports to appropriate department.

Qualifications
What You Will Need:

* Current state of Texas registered nurse licensure
* Must have a minimum of 3 continuous years experience in an acute care setting, preferably hospital, or at least 2 years experience in case management / utilization review with managed care company and 2-3 years experience in an acute care setting.
* Knowledge of medical terminology, disease process and continuum of care for medical-surgical patients.

Job Summary:

The Case Manager develops, implements and monitors a comprehensive Utilization Management program in conjunction with Social Service/Discharge Planning Risk Management. Provides hospital and Medical Staff with guidance in total quality management principles and utilization of services in order to preserve the Texas Health Mansfield's commitment to quality patient care.

This facility is an equal opportunity employer and complies with federal, state and local anti-discrimination laws, regulations and ordinances.