DescriptionSummary: The Utilization Management Nurse I is responsible for determining the clinical appropriateness of care provided to patients and ensuring proper hospital resource utilization of services. This Nurse is responsible for performing a variety of pre-admission, concurrent, and retrospective UM related reviews and functions. They must competently and accurately utilize approved screening criteria (InterQual/MCG/Centers for Medicare and Medicaid Services “CMS” Inpatient List). They effectively and efficiently manage a diverse workload in a fast-paced, rapidly changing regulatory environment and are responsible for maintaining current and accurate knowledge regarding commercial and government payors and Joint Commission regulations and guidelines related to UM. This Nurse effectively communicates with internal and external clinical professionals, efficiently organizes the financial insurance care of the patients, and relays clinical data to insurance providers and vendors to obtain approved certification for services. The Utilization Management Nurse collaborates as necessary with other members of the health care team to ensure the above according to the mission of CHRISTUS. Responsibilities: Meets expectations of the applicable OneCHRISTUS Competencies: Leader of Self, Leader of Others, or Leader of Leaders. Applies demonstrated clinical competency and judgment in order to perform comprehensive assessments of clinical information and treatment plans and apply medical necessity criteria in order to determine the appropriate level of care. Resource/Utilization Management appropriateness: Assess assigned patient population for medical necessity, level of care, and appropriateness of setting and services. Utilizes MCG/InterQual Care Guidelines and/or health system-approved tools to track impact and variance. Uses appropriate criteria sets for admission reviews, continued stay reviews, outlier reviews, and clinical appropriateness recommendations. Coordinate and facilitate correct identification of patient status. Analyze the quality and comprehensiveness of documentation and collaborate with the physician and treatment team to obtain documentation needed to support the level of care. Facilitates joint decision-making with the interdisciplinary team regarding any changes in the patient status and/or negative outcomes in patient responses. Demonstrates, maintains, and applies current knowledge of regulatory requirements relative to the work process in order to ensure compliance, i. e. IMM, Code 44. Demonstrate adherence to the CORE values of CHRISTUS. Utilize independent scope of practice to identify, evaluate, and provide utilization review services for patients and analyze information supplied by physicians (or other clinical staff) to make timely review determinations, based on appropriate criteria and standards. Take appropriate follow-up action when established criteria for utilization of services are not met. Proactively refer cases to the physician advisor for medical necessity reviews, peer-to-peer reviews, and denial avoidance. Effectively collaborate with the Interdisciplinary team including the Physician Advisor for secondary reviews. Proactively review patients at the point of entry, prior to admission, to determine the medical necessity of a requested hospitalization and the appropriate level of care or placement for the patient. Review surgery schedule to ensure planned surgeries are ordered in the appropriate status and that necessary authorization has been obtained as required by the payor or regulatory guidance (i. e., CMS Inpatient Only List, Payor Prior Authorization matrix, etc.) Regularly review patients who are in the hospital in Observation status to determine if the patient is appropriate for discharge or if conversion to inpatient status is appropriate. Proactively identify and resolve issues regarding clinical appropriateness recommendations, coverage, and potential or actual payor denials. Maintain consistent communication and exchange of information with payors as per payor or regulatory requirements to coordinate certification of hospital services. Coordinate and facilitate patient care progression throughout the continuum and communicate and document to support medical necessity at each level of care. Evaluate care administered by the interdisciplinary health care team and advocate for standards of practice. Analyze assessment data to identify potential problems and formulate goals/outcomes. Follows the CHRISTUS Guidelines related to the Health Insurance Portability and Accountability ACT (HIPPA) designed to prevent or detect unauthorized disclosure of Protected Health Information (PHI). Attend scheduled department staff meetings and/or interdepartmental meetings as appropriate. Possesses and demonstrates technology literacy and the ability to work in multiple technology systems. Act as a catalyst for change in the organization; respond to change with flexibility and adaptability; demonstrate the ability to work together for change. Translate strategies into action steps; monitor progress and achieve results. Demonstrate the confidence, drive, and ability to face and overcome challenges and obstacles to achieve organizational goals. Demonstrate competence to perform assigned responsibilities in a manner that meets the population-specific and developmental needs of patients served by the department. Possess negotiating skills that support the ability to interact with physicians, nursing staff, administrative staff, discharge planners, and payers. Excellent verbal and written communication skills, knowledge of clinical protocol, normative data, and health benefit plans, particularly coverage and limitation clauses. Must adjust to frequently changing workloads and frequent interruptions. May be asked to work overtime or take calls. May be asked to travel to other facilities to assist as needed. Must have excellent verbal and written communication and ability to interact with diverse populations. Must have critical and analytical thinking skills. Must have demonstrated clinical competency. Must have the ability to Multitask and to function in a stressful and fast-paced environment. Must have working knowledge of discharge planning, utilization management, case management, performance improvement, and managed care reimbursement. Must have an understanding of pre-acute and post-acute levels of care and community resources. Must have the ability to work independently and exercise sound judgment in interactions with physicians, payors, patients, and their families. Must have an understanding of internal and external resources and knowledge of available community resources. Must have familiarity with criteria sets including InterQual and MCG preferred. Other duties as assigned. Job Requirements: Education/Skills Graduate of an accredited school of nursing required. Experience A minimum of 2 years in acute clinical practice as a nurse. Case Management and Utilization Review experience preferred. Licenses, Registrations, or Certifications LVN or LPN License in state of employment or compact required. BLS preferred. Certification in Case Management preferred. Work Schedule: Varies Work Type: Full Time EEO is the law - click below for more information: https://www.eeoc.gov/sites/default/files/2023-06/22-088_EEOC_KnowYourRights6.12ScreenRdr.pdf We endeavor to make this site accessible to any and all users. If you would like to contact us regarding the accessibility of our website or need assistance completing the application process, please contact us at .

River Ridge Nursing and Rehabilitation CenterCertified Dietary ManagerMust have Certification or in process of obtaining Dietary Manager certification.Must have previous experience in a skilled nursing communityHere’s what’s in it for YOU!A place where your voice mattersCompetitive compensation and benefit packagePaycheck advancesTuition Reimbursement401(k) matchingAccrue paid time off starting day 1Numerous bonus opportunitiesTouchstone Emergency Assistance Foundation GrantsMake Lives Better. Be a part of something meaningful: The Touchstone Experience.If your purpose is to Make Lives Better, we welcome you to Join Team Touchstone today and be part of something meaningful. Touchstone is committed to bringing a Best In Class Healthcare Experience to our Patients, Residents and Veterans. Compassionate team members are the key to revealing our vision to be the leading post-acute healthcare solution in the markets we serve. If you desire to be part of a work environment where every voice matters, we encourage you to apply today. Qualifications: A current Food Service Supervisor certification is required.Minimum of one year of experience as a foodservice supervisor in long term care required. EOE STATEMENTWe are an equal employment opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, disability status, protected veteran status or any other characteristic protected by law.

Description IntroductionAre you looking for a place to deliver excellent care patients deserve At Corpus Christi Medical Center we support our colleagues in their positions. Join our Team as a(an) Registered Nurse Case Manager PRN and access programs to assist with every stage of your career.BenefitsCorpus Christi Medical Center, offers a total rewards package that supports the health, life, career and retirement of our colleagues. The available plans and programs include:Comprehensive medical coverage that covers many common services at no cost or for a low copay. Plans include prescription drug and behavioral health coverage as well as free telemedicine services and free AirMed medical transportation.Additional options for dental and vision benefits, life and disability coverage, flexible spending accounts, supplemental health protection plans (accident, critical illness, hospital indemnity), auto and home insurance, identity theft protection, legal counseling, long-term care coverage, moving assistance, pet insurance and more.Free counseling services and resources for emotional, physical and financial wellbeing401(k) Plan with a 100% match on 3% to 9% of pay (based on years of service)Employee Stock Purchase Plan with 10% off HCA Healthcare stockFamily support through fertility and family building benefits with Progyny and adoption assistance.Referral services for child, elder and pet care, home and auto repair, event planning and moreConsumer discounts through Abenity and Consumer DiscountsRetirement readiness, rollover assistance services and preferred banking partnershipsEducation assistance (tuition, student loan, certification support, dependent scholarships)Colleague recognition programTime Away From Work Program (paid time off, paid family leave, long- and short-term disability coverage and leaves of absence)Employee Health Assistance Fund that offers free employee-only coverage to full-time and part-time colleagues based on income.Learn more about Employee BenefitsNote: Eligibility for benefits may vary by location.Are you a continuous learner With more than 94,000 nurses throughout HCA Healthcare, we are one of the largest employers of nurses in the United States. Education is key to excellence! As a majority owner of Galen College of Nursing, which joins Research College of Nursing and Mercy School of Nursing as educational facilities within the HCA Healthcare family, we make it easier and more affordable to gain certifications and job skills. Apply today for our Registered Nurse Case Manager PRN opening and continue to learn!Job Summary and QualificationsThe RN case manager is responsible to facilitate 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 has overall responsibility for ensuring that care is provided at the appropriate level of care based on medical necessity and to assess 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:What you will do in this role:Actively participates in the collaborative program which requires review of patient activities related to medical necessity of hospitalization, appropriateness of length of stay, timely and appropriate utilization of services rendered, and identification of patient needs related to patient care following discharge from the hospital.The case manager promotes quality care and cost-effective outcomes to enhance the physical, psychosocial and vocational health of individuals.The position encompasses reviewing, planning, implementing, coordinating and evaluating health-related service options throughout the continuum.Employee will be responsible for knowledge and skill necessary to provide care based on physical, psychological, educational, safety and related criteria for the neonate, infant child, adolescent, adult and geriatric population.What you will need for this role:Associate Degree in Nursing, requiredBachelor's Degree in Nursing, preferredCase Management certification, preferredCurrent Texas licensure with State Board of Nurse Examiners as an RN1+ years experience in healthcareCorpus Christi Medical Center is a 630+ bed healthcare system of hospitals in Corpus Christi and the surrounding Coastal Bend community. Bay Area is our full-service acute care hospital and offers state-of-the-art cardiovascular services, bariatric, GYN and robotic surgery. The Women’s Center at Bay Area, with its NICU Unit, is also the home of our graduate medical education program. Doctors Regional is our acute care hospital, with a 24-hour emergency department, cardiac catheterization labs, orthopedic and surgical services, and inpatient rehabilitation. The Heart Hospital offers complete diagnostics, treatment, surgery and rehabilitation for cardiac patients. Northwest Regional/Northwest Behavior Health Center provides emergency medical services, laboratory, imaging services and outpatient behavioral health services. Bayview Behavioral Hospital provides inpatient and outpatient short-term treatment for psychiatric patients ages 12 years and older, as well as substance abuse treatment. Northshore Emergency Center is a full-service 24-7 emergency department in Portland that offers outpatient laboratory, imaging and occupational services. Radiation Oncology offers advanced technology for treating cancer with the latest and most specific radiation therapies available. Our programs focus on the needs of individual patients, while employing the latest techniques and research of 21st-century medicine. HCA Healthcare has been recognized as one of the World’s Most Ethical Companies® by the Ethisphere Institute more than ten times. In recent years, HCA Healthcare spent an estimated $3.7 billion in cost for the delivery of charitable care, uninsured discounts, and other uncompensated expenses. "Good people beget good people."- Dr. Thomas Frist, Sr.HCA Healthcare Co-Founder If growth and continued learning is important to you, we encourage you to apply for our Registered Nurse Case Manager PRN opening. Our team will promptly review your application. Highly qualified candidates will be contacted for interviews. Unlock the possibilities apply today!We are an equal opportunity employer. We do not discriminate on the basis of race, religion, color, national origin, gender, sexual orientation, age, marital status, veteran status, or disability status.

Description IntroductionWant to join a team of daring managers who care without reservations or limits Our Corpus Christi Medical Center Bay Area team is looking for a(an) RN Manager Labor and Delivery. HCA Healthcare is an advanced healthcare network that has committed up to $300 million to our incredible team members over the course of three years.BenefitsCorpus Christi Medical Center Bay Area, offers a total rewards package that supports the health, life, career and retirement of our colleagues. The available plans and programs include:Comprehensive medical coverage that covers many common services at no cost or for a low copay. Plans include prescription drug and behavioral health coverage as well as free telemedicine services and free AirMed medical transportation.Additional options for dental and vision benefits, life and disability coverage, flexible spending accounts, supplemental health protection plans (accident, critical illness, hospital indemnity), auto and home insurance, identity theft protection, legal counseling, long-term care coverage, moving assistance, pet insurance and more.Free counseling services and resources for emotional, physical and financial wellbeing401(k) Plan with a 100% match on 3% to 9% of pay (based on years of service)Employee Stock Purchase Plan with 10% off HCA Healthcare stockFamily support through fertility and family building benefits with Progyny and adoption assistance.Referral services for child, elder and pet care, home and auto repair, event planning and moreConsumer discounts through Abenity and Consumer DiscountsRetirement readiness, rollover assistance services and preferred banking partnershipsEducation assistance (tuition, student loan, certification support, dependent scholarships)Colleague recognition programTime Away From Work Program (paid time off, paid family leave, long- and short-term disability coverage and leaves of absence)Employee Health Assistance Fund that offers free employee-only coverage to full-time and part-time colleagues based on income.Learn more about Employee BenefitsNote: Eligibility for benefits may vary by location.HCA Healthcare is committed to research and clinical protocols. Do you want to impact standards of care and save lives across the country Apply today to our RN Manager Labor and Delivery and be a part of the innovation of ideas.Job Summary and QualificationsThe Manager ensures high quality, patient-centered care through oversight of the overall daily function and staffing ofthe unit/department. The Manager monitors and evaluates theprovision of nursing care in accordance with establishedpolicies/procedures and holds staff accountable for quality and clinical outcomes in support of facility objectives.Education & Experience:• Associate Degree in Nursing or RN Diploma Required• Bachelor's Degree in Nursing Preferred• 1+ years applicable experience RequiredCorpus Christi Medical Center is a 630+ bed healthcare system of hospitals in Corpus Christi and the surrounding Coastal Bend community. Bay Area is our full-service acute care hospital and offers state-of-the-art cardiovascular services, bariatric, GYN and robotic surgery. The Women’s Center at Bay Area, with its NICU Unit, is also the home of our graduate medical education program. Doctors Regional is our acute care hospital, with a 24-hour emergency department, cardiac catheterization labs, orthopedic and surgical services, and inpatient rehabilitation. The Heart Hospital offers complete diagnostics, treatment, surgery and rehabilitation for cardiac patients. Northwest Regional/Northwest Behavior Health Center provides emergency medical services, laboratory, imaging services and outpatient behavioral health services. Bayview Behavioral Hospital provides inpatient and outpatient short-term treatment for psychiatric patients ages 12 years and older, as well as substance abuse treatment. Northshore Emergency Center is a full-service 24-7 emergency department in Portland that offers outpatient laboratory, imaging and occupational services. Radiation Oncology offers advanced technology for treating cancer with the latest and most specific radiation therapies available. Our programs focus on the needs of individual patients, while employing the latest techniques and research of 21st-century medicine. HCA Healthcare has been recognized as one of the World’s Most Ethical Companies® by the Ethisphere Institute more than ten times. In recent years, HCA Healthcare spent an estimated $3.7 billion in cost for the delivery of charitable care, uninsured discounts, and other uncompensated expenses. "Good people beget good people."- Dr. Thomas Frist, Sr.HCA Healthcare Co-Founder Unlock your potential with a leading healthcare provider dedicated to its patients, colleagues and communities. Help guide our team as a(an) RN Manager Labor and Delivery and help us improve more lives in more ways.We are an equal opportunity employer. We do not discriminate on the basis of race, religion, color, national origin, gender, sexual orientation, age, marital status, veteran status, or disability status.

The Key Carrier role is an elevated extension of the Coordinator role. Key Carriers alternate their role based on store needs, predominantly performing the role of Coordinator and occasionally acting as Key Carrier, taking on a leadership role in maintaining all aspects of the store. Key Carriers must have open availability, including nights and weekends. Role models exceptional customer service.Creates a positive internal and external customer experiencePromotes a culture of honesty and integrity; maintains confidentialityActs as Manager on Duty adhering to company policy and procedureEnsures store team performs tasks and activities in accordance with store plan; prioritizes as neededAddresses immediate customer service issues and provides appropriate coaching to AssociatesExercises discretion regarding customer service policies to satisfy customersMaintains accurate Associate coverage in service areas for a positive customer experienceEnsures Associates adhere to all operational proceduresEnsures opening/closing procedures are executed according to company guidelinesCommunicates accurately and effectively with management and Associates when setting and addressing priorities; provides progress updatesProvides and accepts recognition and constructive feedbackProvides feedback, recognition and coaching to AssociatesPartners with Management on Associate training needs to increase effectivenessEnsures adherence to all labor laws, policies, and proceduresPromotes credit and loyalty programsSupports and participates in shrink reduction goals and programsPromotes safety awareness and maintains a safe environmentOther duties as assignedWho We Are Looking For: You!Able to work a flexible schedule, including nights and weekendsTeam player, working effectively with peers and supervisorsAble to respond appropriately to changes in direction or unexpected situationsKnowledge of company standard software, systems, and proceduresKnowledge of merchandise flow in storesProven problem solving skillsAble to effectively coach, delegate, and follow-up on multiple people/tasksAble to act quickly under challenging circumstancesCapable of multi-taskingSuperior communication and organizational skills with attention to detail1 year retail, 6 months leadership experienceBenefits include: Associate discount; EAP; smoking cessation; bereavement; 401(k) Associate contributions; child care & cell phone discounts; pet & legal insurance; credit union; referral bonuses. Those who meet service or hours requirements are also eligible for: 401(k) match; medical/dental/vision; HSA; health care FSA; life insurance; short/long term disability; paid parental leave; paid holidays/vacation/sick; auto/home insurance discounts; scholarship program; adoption assistance. All benefits are provided in accordance with and subject to the terms of the applicable plan or program and may change from time to time. Contact your TJX representative for more information.This position has a starting pay range of $14.00 to $14.50 per hour.Actual starting pay is determined by a number of factors, including relevant skills, qualifications, and experience.Applicants with arrest or conviction records will be considered for employment.We’re reinventing retail and helping people discover that next find that’s going to be their new signature look. You can be a part of their journey to look amazing.Our inventory is always changing and our approach is continually evolving, which means every day is another chance to Discover Different. In fact, that’s what it’s like throughout the entire TJX family, which includes TJ Maxx, HomeGoods, Sierra, and Homesense.Discover Different also means we embrace each other’s differences and unique perspectives. We consider all applicants for employment without regard to race, color, religion, gender, sexual orientation, national origin, age, disability, gender identity and expression, marital or military status. We also provide reasonable accommodations to qualified individuals with disabilities in accordance with the Americans with Disabilities Act and applicable state and local law.

Accountable for Merchandising, Operations, Customer Service and Human Resources within a high-volume store locationDevelop creative plans to increase store salesManage store expense control and payroll to optimize businessFocus staff on Loss Prevention prioritiesEnsure every customer has a positive shopping experienceRecruit, train, develop and manage a large team of Associates and Assistant ManagersProvide individualized development for Assistant Store Managers to ensure their ability to be promoted to Store Manager positionsWho We Are Looking For: You!Three to five years' retail leadership experience as a Store or District ManagerProven ability to manage, develop and motivate a large teamPrevious volume responsibility of $5 million or moreStrong interpersonal, communication and follow through skillsBenefits include Associate discount; 401(k) match; medical/dental/vision; HSA; health care FSA; life insurance; short/long-term disability; paid holidays/vacation /sick/bereavement/parental leave; EAP; incentive programs; auto/home insurance discounts; scholarship program; adoption/surrogacy assistance; smoking cessation; child care/cell phone discounts; pet/legal insurance; credit union; referral bonuses. All benefits are subject to applicable plan or program terms (including eligibility terms) and may change from time to time. Contact your TJX representative for more information.This is a bonus eligible position with a starting pay range of $73,400.00 to $100,900.00 annually.Actual starting pay is determined by a number of factors, including relevant skills, qualifications, and experience.Applicants with arrest or conviction records will be considered for employment.At HomeGoods, we embrace the unknown - with new products, new challenges and new ways to make a house a home. Our products add little, special touches to customers' lives and our people do the same for each other. Everyone supports each other to Discover Different - here and throughout the entire TJX family, which includes TJ Maxx, Marshalls, Sierra, and Homesense.Discover Different means we embrace each other’s differences and unique perspectives. We consider all applicants for employment without regard to race, color, religion, gender, sexual orientation, national origin, age, disability, gender identity and expression, marital or military status. We also provide reasonable accommodations to qualified individuals with disabilities in accordance with the Americans with Disabilities Act and applicable state and local law.

DescriptionSummary: The RN, Care Manager (CM) II works in collaboration with the patient/family, physicians and multidisciplinary team members to ensure patient progression through the continuum of care and to develop a plan of care for each assigned patient from admission through discharge. The CM is responsible for identifying, initiating and managing optimal patient flow/throughput to enhance continuity of care, smooth and safe transitions, patient satisfaction, patient safety, and length of stay management. Support and expertise are provided through comprehensive assessment, planning, implementation, and overall evaluation of individual patient needs. Care Coordination and Discharge Planning are both responsibilities of this role. The CM assesses and responds to patient/family needs by coordinating efforts of other team members and identifies and resolves barriers that hinder effective patient care. The CM adheres to departmental and organizational goals, objectives, standards of performance, policies and procedures, and continually assures regulatory compliance. Responsibilities: Meets expectations of the applicable OneCHRISTUS Competencies: Leader of Self, Leader of Others, or Leader of Leaders. Coordinates the integration of case management functions into the patient care and discharge planning processes in collaboration with other hospital departments, external service organizations, agencies, and healthcare facilities. Coordinates/facilitates patient care progression throughout the continuum of care in an efficient and cost-effective manner. Serves as resource, provides support, and advocates on behalf of the patient related to treatment decisions and end of life issues. Closely monitor patient length of stay in regard to the geometric mean length of stay and communicate/collaborate with appropriate interdisciplinary team members to remove barriers and expedite discharge. Implements and monitors the patient’s plan of care to ensure effectiveness and appropriateness of services. Identifies and escalates local and system barriers that are impeding diagnostic or treatment progress and issues related to quality and risk as appropriate in a timely manner. Proactively identifies and resolves delays and obstacles to discharge. Uses advanced conflict resolution skills as necessary to ensure timely resolution of issues. Collaborates with medical staff, nursing staff, and ancillary staff to eliminate barriers to efficient delivery of care in the appropriate setting. Interviews patients/families to obtain information about social, emotional, and financial factors which impact health status to develop comprehensive discharge planning assessment and care plan. Assesses needs for discharge planning and continuing care/resource support following discharge; independently makes recommendations to patients and families regarding post-acute level of care needs and options including:Acute Rehabilitation PlacementNursing Home or Skilled Nursing placementPsychiatric or Substance Abuse placementNew DialysisChild/Adult/Domestic AbuseHome Health/Hospice ReferralsLegal issues (adoptions, guardianship)Assistance with Advance DirectivesCommunity Resource needsFinancial Issues/Funding optionsDME Referrals and CoordinationSocial Determinants of HealthInitiates discharge planning at the time of admission and makes post-hospital service referrals based upon information gathered during assessment and interactions with physicians, multidisciplinary care team, and payors as indicated. Acts as patient advocate by negotiating for, and coordinating, resources with payors, agencies, and vendors. Ensures that all elements critical to the plan of care have been communicated to the patient/family and members of the healthcare team and are documented as necessary to assure continuity of care. Provide appropriate interventions which demonstrate knowledge of and sensitivity toward cultural diversity and the religious, developmental, health literacy, and educational backgrounds of the patient population. Assesses the patient’s formal and informal support system as well as available benefits and/or community resources. Meets directly with patient/family to assess needs and develop and individualized care plan in collaboration with the physician. Ensures and maintains plan consensus from patient/family, physician and payor. Provides education, information, direction, and support related to patient’s goals of care. Acts as patient advocate to develop treatment plan and coordinate patient care and to transition patient to the appropriate next level of care. Demonstrates and promotes respect for the dignity and rights of every patient while adhering to the safety standards and practices of the organization and the nursing profession. Collaborates with the physician and other health care professionals to promote appropriate use of medical center resources. Provides information and support to patients and families, helping them access needed resources within the medical center and community. Actively participates in clinical performance improvement activities involving length of stay, resource utilization, avoidable days, cost per case, and readmissions. Measures effectiveness of interventions through direct communication with post-acute care providers, patients, and caregivers. Promotes individual professional growth and development by meeting requirements for mandatory/continuing education and skills competency. Actively participates in Multidisciplinary/Patient Care Progression Rounds. Escalates cases as appropriate and per policy to Physician Advisors and/or CM Director. Documents in the medical record per regulatory and department guidelines. May be asked to assist with special projects. May serve a preceptor or orienter to new associates. Assumes responsibility for professional growth and development. Must have excellent verbal and written communication and ability to interact with diverse populations. Must have critical and analytical thinking skills. Must have demonstrated clinical competency. Must have the ability to Multitask and to function in a stressful and fast paced environment. Must have working knowledge of discharge planning, utilization management, case management, performance improvement, and managed care reimbursement. Must have understanding of pre-acute and post-acute levels of care and community resources. Must have ability to work independently and exercise sound judgment in interactions with physicians, payors, patients and their families. Must be understanding of internal and external resources and knowledge of available community resources. Must have the ability to move around the hospital to all areas for the majority of the workday while in office the rest of the day; general office and hospital environment. Job Requirements: Education/Skills Graduate of an accredited school of nursing (BSN preferred) or Masters Degree in Social Work (MSW) required or demonstrated success in CHRISTUS Care Manager I Position for at least 5 years on top of the required experience in lieu of education required. Experience Two or more years clinical experience with one year in the acute care setting preferred. Licenses, Registrations, or Certifications RN or LMSW in the state of employment is required for new hires. LBSW accepted for associates with 5+ years of demonstrated success and experience in CHRISTUS Care Manager I role. Certification in Case Management preferred. BLS preferred. Work Schedule: 8AM - 5PM Monday-Friday Work Type: Full Time EEO is the law - click below for more information: https://www.eeoc.gov/sites/default/files/2023-06/22-088_EEOC_KnowYourRights6.12ScreenRdr.pdf We endeavor to make this site accessible to any and all users. If you would like to contact us regarding the accessibility of our website or need assistance completing the application process, please contact us at .

DescriptionSummary: The RN Supervisor is accountable for supervising the delivery of high-quality, cost-effective care to patients. Responsible in assisting the Director for analyzing, planning, implementing, evaluating, and communicating processes and programs which enhance, strengthen and integrate the services comprising the nursing department. Responsible for participation in the development and implementation of the service line strategic business plans; and for creating an environment, which continuously supports improvement of operational, financial, and clinical components. Assumes primary responsibility for effective supervision of nursing activities of assigned area(s). Assists management of financial and human resources to ensure services meet established quality and productivity standards. Provides feedback and assistance concerning customer satisfaction, staff development, and associate performance and satisfaction. The Supervisor is responsible for the daily operations of a Nursing department on a 24-hour basis. The Supervisor collaborates with other clinical and ancillary departments to meet organizational and department-specific Quality and Safety Measures, Community Values, Business Literacy, and Service Excellence goals. A3 is a 24-bed unit providing high-acuity care for cardiac and medical-surgical patients with various co-morbidities. We care for post-cardiac intervention patients (e. g., heart catheterizations, AAA stent repairs, TAVRs, EP ablations, pacemaker/ICD placements) and manage specialized devices like Impellas and IABPs, Artic Sun and Tablo XT. We also treat ventilator-dependent patients and those with conditions like hypertension, diabetes, GI bleeds, peripheral vascular disease and renal disease. The unit handles multiple infusions for blood pressure, cardiac issues, thrombolytics, sedation and paralytics, as well as post-surgical ICU care. Our goal is to deliver exceptional, evidence-based care through teamwork and positive outcomes. Responsibilities: Meets expectations of the applicable OneCHRISTUS Competencies: Leader of Self, Leader of Others, or Leader of Leaders. Implementing and monitoring programs and practices for the delivery of safe and efficient quality nursing care for patients and their families. Ensuring consistent application of nursing services policies and standards throughout the organization. Monitoring patient outcomes and quality and effectiveness of nursing care. Overseeing the performance of teams; identifying and addressing staff training and development needs. Standard I. Human Resources Management Evaluates and specifies the critical resources required to accomplish the team's objectives. Initiates requests for required resources based on staff competency with patient acuity. Allocates team resources responsibly and equitably within the scope of labor laws. Discovers opportunities to improve resource utilization. Implements changes in role consistent with scope of practice. Anticipates and plans for admission/discharge/transfer needs to facilitate patient flow. Resolves conflicts in a wide variety of situations, such as workload or resource allocation, patient and family concerns, patient through-put and capacity needs, associate engagement challenges, etc. Adjusts management and personal style to fit the needs of different people and different situations. Explores motivational factors and tailor's motivational efforts to individual needs and situations for the department. Conducts evaluations on personnel performance at the workplace and recommends improvement plans. Coaches others on operating personnel management systems and their processes. Manages day-to-day labor needs by maintaining optimum staffing levels. Standard II. Relationship Management and Influencing Behaviors Applies principles of crisis management to identify issues that require immediate attention, handle situations as necessary, and manage conflict. Mentors and coach's staff. Encourages participation in professional organization. Embraces principles of self-awareness. Fosters a healthy work environment and encourages stress management. Promotes Diversity and team dynamics and understands the components of cultural competence as they apply to the workforce. Capitalizes on differences and maintains an environment of fairness to foster highly effective work groups. Standard III. Performance Improvement/Safe Practice/Quality Care/Regulations Assesses customer and patient satisfaction while developing and implementing strategies to address satisfaction issues. Provides direct service to internal or external customers and facilitates the resolution of customer problems, issues, or concerns. Monitors and promotes workplace safety requirements resulting in positive patient outcomes. Supports nursing research and quality improvement activities. Provides evidence-based nursing care. Promotes and communicates patient information effectively across the continuum of care. Standard IV. Leadership Serves as a leader of patient care. Utilizes an appropriate style of leadership: autocratic, democratic, laissez-faire/free rein, etc. Demonstrates leadership qualities: intelligence, influence, determination, integrity, confidence. Manages own behaviors during interactions, such as feedback giving, to shape workplace events. Utilizes positive reinforcement to motivate and attain desired behaviors; increases productivity. Clinical Performance Improvement Shares experiences with process performance improvements across multiple areas. Recognizes recurring and difficult problems and explores new or innovative solutions. Leverages technology to facilitate the sharing of clinical performance or outcomes data. Creates mechanism for ensuring quality and performance measures are understood and valued by nursing staff. Implements and supports improvement initiatives at the unit level. Clinical Policies and Standards Monitors different types of clinical practice to ensure compliance with standards and their impact on the organization. Informs others on advanced clinical standards and policies across medical specialties. Collaborates with other functions in establishing and documenting joint standards. Participates in the development of clinical policies and practices. Healthcare Policy and Ethics Compliance Shares experiences with addressing diverse problems in healthcare policy compliance. Demonstrates best practices for dealing with complex compliance or non-compliance situations. Guides others in making correct decisions when faced with ethical dilemmas. Supports and coaches on mechanisms that encourage attention to compliance issues, all clinical activities. Healthcare Regulatory Environment Implements programs as needed to comply with diverse healthcare laws or regulations. Monitors regulatory compliance of all healthcare practices in preparation for external audits to ensure no violations. Job Requirements: Education/Skills Bachelor of Science Degree in Nursing required for Magnet facilities, otherwise preferred. Experience 2 years of clinical patient care experience in a relevant setting. Previous Lead or Supervisor experience overseeing work of assigned units, preferred. Previous healthcare management experience preferred. Licenses, Registrations, or Certifications BLS required. RN License in state of employment or compact. ACLS required within 6 months of hire/transfer dateNIHSS required within 90 days of hire/transfer dateDe-escalation training required within 90 days of hire/transfer dateAdditional certifications must be completed by the specified time frame for facilities listed below:Alice/Beeville/Kleberg- NRP within 90 days of hire/transfer date Work Schedule: Varies Work Type: Full Time EEO is the law - click below for more information: https://www.eeoc.gov/sites/default/files/2023-06/22-088_EEOC_KnowYourRights6.12ScreenRdr.pdf We endeavor to make this site accessible to any and all users. If you would like to contact us regarding the accessibility of our website or need assistance completing the application process, please contact us at .

DescriptionSummary: The Utilization Management Nurse II is responsible for determining the clinical appropriateness of care provided to patients and ensuring proper hospital resource utilization of services. This Nurse is responsible for performing a variety of pre-admission, concurrent, and retrospective UM related reviews and functions. They must competently and accurately utilize approved screening criteria (InterQual/MCG/Centers for Medicare and Medicaid Services “CMS” Inpatient List). They effectively and efficiently manage a diverse workload in a fast-paced, rapidly changing regulatory environment and are responsible for maintaining current and accurate knowledge regarding commercial and government payors and Joint Commission regulations and guidelines related to UM. This Nurse effectively communicates with internal and external clinical professionals, efficiently organizes the financial insurance care of the patients, and relays clinical data to insurance providers and vendors to obtain approved certification for services. The Utilization Management Nurse collaborates as necessary with other members of the health care team to ensure the above according to the mission of CHRISTUS. CHRISTUS Spohn Hospital Corpus Christi - Shoreline overlooking Corpus Christi Bay is the largest and foremost acute care medical facility in the region, with a full range of diagnostic and surgical specialty services in cardiac, cancer, and stroke care. It is the leading emergency facility in the area with a Level II Trauma Center in the Coastal Bend, staffed with physicians and nurses specially trained in emergency services. The Pavilion and North Tower house a state-of-the-art emergency department, ICU, Cardiac Cath Lab and surgical suitesA teaching facility in affiliation with the Texas A&M University System Health and Science Center College of MedicineAccredited Chest Pain CenterAccredited Joint Commission Stroke Team Responsibilities: Meets expectations of the applicable OneCHRISTUS Competencies: Leader of Self, Leader of Others, or Leader of Leaders. Applies demonstrated clinical competency and judgment in order to perform comprehensive assessments of clinical information and treatment plans and apply medical necessity criteria in order to determine the appropriate level of care. Resource/Utilization Management appropriateness: Assess assigned patient population for medical necessity, level of care, and appropriateness of setting and services. Utilizes MCG/InterQual Care Guidelines and/or health system-approved tools to track impact and variance. Uses appropriate criteria sets for admission reviews, continued stay reviews, outlier reviews, and clinical appropriateness recommendations. Coordinate and facilitate correct identification of patient status. Analyze the quality and comprehensiveness of documentation and collaborate with the physician and treatment team to obtain documentation needed to support the level of care. Facilitates joint decision-making with the interdisciplinary team regarding any changes in the patient status and/or negative outcomes in patient responses. Demonstrates, maintains, and applies current knowledge of regulatory requirements relative to the work process in order to ensure compliance, i. e. IMM, Code 44. Demonstrate adherence to the CORE values of CHRISTUS. Utilize independent scope of practice to identify, evaluate and provide utilization review services for patients and analyze information supplied by physicians (or other clinical staff) to make timely review determinations, based on appropriate criteria and standards. Take appropriate follow-up action when established criteria for utilization of services are not met. Proactively refer cases to the physician advisor for medical necessity reviews, peer-to-peer reviews, and denial avoidance. Effectively collaborate with the Interdisciplinary team including the Physician Advisor for secondary reviews. Proactively review patients at the point of entry, prior to admission, to determine the medical necessity of a requested hospitalization and the appropriate level of care or placement for the patient. Review surgery schedule to ensure planned surgeries are ordered in the appropriate status and that necessary authorization has been obtained as required by the payor or regulatory guidance (i. e., CMS Inpatient Only List, Payor Prior Authorization matrix, etc.) Regularly review patients who are in the hospital in Observation status to determine if the patient is appropriate for discharge or if conversion to inpatient status is appropriate. Proactively identify and resolve issues regarding clinical appropriateness recommendations, coverage, and potential or actual payor denials. Maintain consistent communication and exchange of information with payors as per payor or regulatory requirements to coordinate certification of hospital services. Coordinate and facilitate patient care progression throughout the continuum and communicate and document to support medical necessity at each level of care. Evaluate care administered by the interdisciplinary health care team and advocate for standards of practice. Analyze assessment data to identify potential problems and formulate goals/outcomes. Follows the CHRISTUS Guidelines related to the Health Insurance Portability and Accountability ACT (HIPPA) designed to prevent or detect unauthorized disclosure of Protected Health Information (PHI). Attend scheduled department staff meetings and/or interdepartmental meetings as appropriate. Possesses and demonstrates technology literacy and the ability to work in multiple technology systems. Act as a catalyst for change in the organization; respond to change with flexibility and adaptability; demonstrate the ability to work together for change. Translate strategies into action steps; monitor progress and achieve results. Demonstrate the confidence, drive, and ability to face and overcome challenges and obstacles to achieve organizational goals. Demonstrate competence to perform assigned responsibilities in a manner that meets the population-specific and developmental needs of patients served by the department. Possess negotiating skills that support the ability to interact with physicians, nursing staff, administrative staff, discharge planners, and payers. Excellent verbal and written communication skills, knowledge of clinical protocol, normative data, and health benefit plans, particularly coverage and limitation clauses. Must adjust to frequently changing workloads and frequent interruptions. May be asked to work overtime or take calls. May be asked to travel to other facilities to assist as needed. Actively participates in Multidisciplinary/Patient Care Progression Rounds. Escalates cases as appropriate and per policy to Physician Advisors and/or CM Director. Documents in the medical record per regulatory and department guidelines. May be asked to assist with special projects. May serve as a preceptor or orienter to new associates. Assumes responsibility for professional growth and development. Familiarity with criteria sets including InterQual and MCG preferred. Must have excellent verbal and written communication and ability to interact with diverse populations. Must have critical and analytical thinking skills. Must have demonstrated clinical competency. Must have the ability to Multitask and to function in a stressful and fast-paced environment. Must have working knowledge of discharge planning, utilization management, case management, performance improvement, and managed care reimbursement. Must have an understanding of pre-acute and post-acute levels of care and community resources. Must have the ability to work independently and exercise sound judgment in interactions with physicians, payors, patients, and their families. Must have an understanding of internal and external resources and knowledge of available community resources. Other duties as assigned. Job Requirements: Education/Skills Graduate of an accredited School of Nursing OR demonstrated success in the Utilization Management Nurse I role for at least five years at CHRISTUS Health on top of required experience in lieu of education required. Experience Two or more years of clinical experience with at least one year in the acute care setting OR demonstrated success as Utilization Management Nurse I role at CHRISTUS Health required. Licenses, Registrations, or Certifications RN License in state of employment or compact required. LPN or LVN license accepted for associates with 5+ years of demonstrated success and experience in the Utilization Management Nurse I role at CHRISTUS Health. Certification in Case Management preferred. BLS preferred. Work Schedule: 7PM - 7AM Work Type: Full Time EEO is the law - click below for more information: https://www.eeoc.gov/sites/default/files/2023-06/22-088_EEOC_KnowYourRights6.12ScreenRdr.pdf We endeavor to make this site accessible to any and all users. If you would like to contact us regarding the accessibility of our website or need assistance completing the application process, please contact us at .

Summary This is an opportunity to be the first Physician in a newly purchased and remodeled clinic in a rapidly growing area. The clinic is in an upcoming area of town where many new family homes are currently being built. You would be the only physician in clinic paired with 2 solid advanced practice providers. This is a true Family Medicine practice which provides services to all ages of family members. Approximately 5% pediatrics. Mixture of commercial insurances and Medicare. Lab & X-ray onsite with the ability to send labs to lab corps if needed. Qualifications Completion of US accredited Family Medicine Residency programBoard Eligible or Board Certified in Family MedicineActive or in process Physician license in TexasActive or in process unrestricted DEA licenseStrong listening, written and oral communication skillsAbility to navigate EMR and modern computer programs Competitive Benefits Package includes Competitive Salary & Quarterly BonusesSign on BonusMedical, Dental, VisionLife Insurance: short and long term disability401K with employer matchPaid Holidays and PTO Clinic Information Amarillo, TX 79106Outpatient clinic Monday - Thursday 8am-5pm & Friday 8am-1pmLab & X-ray onsitePhlebotomist onsiteAllergy testing onsiteEMR is Athena One Group Info FMC Health is a locally-owned, healthcare management organization servicing Amarillo, Canyon, and surrounding areas that provides patients a complete continuum of care from pediatrics, urgent, and primary care to long-term, palliative, and hospice care, and everything in between. Seamless integration between services means patients' needs are always prioritized. Combined, we have 75 exceptional health care providers who are trained in the latest techniques and always put the needs of our patients first. We understand that family comes first and that's why we provide the best healthcare professionals to serve our communities.