JOB SUMMARY The individual in this position works under the direction of the RN Case Manager and/or Social Worker (SW) to complete referrals for post acute services for patients and assist with tasks that do not require a clinical license or degree. The individualï¿½s responsibilities include the following activities: a) arrange post-discharge services b) create and follow up on electronic referrals using the Tenet Case Management system, c) review patient choice letters with patients/families for required signatures, d) provide follow up Important Message to Medicare patients prior to discharge, e) communicate with patients, families and other members of the care team, f) complete tasks assigned by Case Manager and Social Work staff, g) make copies, send faxes and complete phone calls, h) complete process reviews or audits as requested, and i) other duties as assigned
Utilization Management: 1.1 Validates patientï¿½s demographic and payer information with patient/family and notifies Patient Access immediately if any corrections are needed 1.2 Validates that all commercial/managed care discharges have an authorization for status and level of care provided and notifies Director of Case Management (DCM) of variances
1.3 Provides Important Message follow up letter to Medicare beneficiaries per Tenet policy and under the direction of the RN Case Manager or Social Worker (15% daily, essential)
Transition Management: 2.0 Makes referrals for post-acute services under the direction of the RN Case Manager or Social Work staff utilizing the electronic Tenet Case Management system
2.1 Provides patients and families with choices of post-acute providers per Tenet policy
2.2 Responds to post-acute providers timely and completes referrals per Tenet policy
2.3 Documents and communicates all elements of the post-acute referral to the RN Case Manager or SW and the healthcare team, patient/family and post-acute providers
2.4 Completes tasks as assigned by RN Case Manager and/or SW staff
2.5 Makes copies, send faxes and complete phone calls to arrange post-acute services and to ensure that appropriate hospital information is communicated to post-acute providers
2.6 Documents all referrals and tasks in the Case Management Documentation system per Tenet policy (70% daily, essential)
Education 3.1 Provides patients and healthcare team information regarding resources and benefits available to the patient along with the economic impact of care options (5ï¿½ily, essential)
Compliance 4.1 Adheres to federal, state, and local regulations and accreditation requirements impacting case management scope of services 4.2 Adheres to department structure and staffing, policies and procedures to comply with the CMS Conditions of Participation and Tenet policies (10% daily, essential)
Required: High School diploma or equivalent required Preferred: Associate or Bachelorï¿½s degree
Required: Two (2) years of experience in clerical or healthcare field Preferred: Paramedic, EMT or Nursing Assistant certification preferred. Acute hospital experience preferred.
Primary Location: Tucson, Arizona
Facility: Carondelet St. Mary's Hospital
Job Type: Full-time
Shift Type: Days
Employment practices will not be influenced or affected by an applicantâ��s or employeeâ��s race, color, religion, sex (including pregnancy), national origin, age, disability, genetic information, sexual orientation, gender identity or expression, veteran status or any other legally protected status. Tenet will make reasonable accommodations for qualified individuals with disabilities unless doing so would result in an undue hardship.
Internal Number: 2005034318
About Carondelet St. Mary's Hospital
Tenet Healthcare Corporation is a diversified healthcare services company with 115,000 employees united around a common mission: to help people live happier, healthier lives. Through its subsidiaries, partnerships and joint ventures, including United Surgical Partners International, the Company operates general acute care and specialty hospitals, ambulatory surgery centers, urgent care centers and other outpatient facilities. Tenet's Conifer Health Solutions subsidiary provides technology-enabled performance improvement and health management solutions to hospitals, health systems, integrated delivery networks, physician groups, self-insured organizations and health plans.