SCA Health Peridot , AZ 85542
Posted 4 weeks ago
Performs case management of assigned patients to ensure coordination of services in accordance with established treatment plan for timely and appropriate transition of patient based on care/service needs
Essential Functions:
Manages and oversees care coordination of assigned patient case load to ensure delivery of all covered services identified for continuity of care across all levels of care and involved providers;
Serves as primary contact/clinical liaison between referral hospitals, treatment facilities and patients/patient's families to ensure delivery of effective and appropriate treatment in accordance with established plan of care
Reviews charts of assigned patients to determine appropriate referral services based on assessed patient needs
Facilitates, schedules and/or participates in a variety of patient care coordination activities to ensure patient and/or family personal and health care needs are met in a timely manner; proactively identifies alternative resources as needed
Collaborates with patient, family members and other involved parties to ensure coordination of care coverage through private and governmental health care plans
Performs utilization review of patient chart to ensure compliance with established criteria to maximize reimbursement/coverage of charges
Receives and responds to all patient complaints; researches issues for corrective action as appropriate based on findings; escalates physician/provider issues to appropriate parties and identifies alternative solutions
Collects, trends and analyzes outcome data to be used in identifying best practices and targeting performance improvement solutions
Participates in departmental orientation, on the job training and quality assurance programs/initiatives
Participates in a variety of department and hospital educational programs to maintain current skill and competency levels; identifies and discusses performance or training needs with Supervisor
Perform other duties as assigned
At least 1 year of recent, relevant case management experience: certification preferred or any other combination of education, training and/or experience
Associates Degree in Nursing, BSN preferred
Current and active state unrestricted RN license, Arizona state license preferred
CPR and ACLS certification or obtain within 30 days of hire
Indian Preference and Equal Employment Opportunity
SCAHC gives preference in hiring to San Carlos Apache Tribal members and other Native Americans in accordance with the San Carlos Apache Tribe's Tribal Preference Policy, as set forth in Section 402 of the Tribe's Human Resources Department Policies and Procedures Manual. Otherwise SCAHC does not discriminate in any way to deprive any person of employment opportunities or otherwise adversely affect him/her because of race, color, religion, sex, sexual orientation, gender identity, national origin, age, disability, citizenship, veteran status, military or uniformed services, in accordance with all applicable governmental laws and regulations. In addition, SCAHC complies with all applicable federal, and Tribal laws governing nondiscrimination in employment.
SCA Health