CARE TRANSITION MANAGER RN FULL-TIME - Stephenville Texas

Company: Texas Health Resources
Location: Stephenville, Texas
Posted On: 11/15/2024

Care Transition Manager RN -Full-time - Work location: Texas Health Stephenville - 411 N. Belknap Street, Stephenville, TX 76104 - Work hours: Full-time, 40 hours/week, Monday-Friday 8:00AM-5:00PMCare Transition Management highlights:Care Transition management - based on the Med/Surg floor, and will work with Med/Surg, ICU and ED patients - Coordinate care with the Hospitalist, Cardiologist, Family Practitioner and Surgeons - Texas Health Harris Methodist Hospital Stephenville is a full-service, 98-bed hospital serving Erath and surrounding counties since 1926. The hospital offers surgical services, women's and infants' services, advanced diagnostic imaging, sleep lab and a wound care program.Here's What You Need - Bachelor of Science in Nursing (BSN) required ; Individuals hired as CTRN prior to May 11, 2017 will be grandfathered to the CTRN position with an RN, at the entity they were employed at on May 11, 2017. - Current RN licensure or compact licensure recognized by the Texas Board of Nursing upon hire - CPR - Cardiopulmonary Resuscitation upon hire Required . - 3 Years Staff Nurse (RN) at an acute care hospital Required - 1 Year discharge planning/care management preferred - ACM - Accredited Case Manager Upon Hire Preferred OrCCM - Certified Case Manager Upon Hire Preferred OrOther ANCC Upon Hire Preferred - Working knowledge of medical necessity criteria preferredKnowledge of Microsoft Outlook and Office (Word, Excel)Customer service skills; Ability to engage in complex clinical decision-makingStrong oral and written communication skillsStrong commitment to interdisciplinary collaborationCritical thinking, analysis and conflict resolution skillsFlexible scheduling as necessaryPsychosocial and crisis intervention skillsAbility to prioritize and meet deadlinesWhat You Will Do: - Responsible for ensuring patients are transitioned to appropriate levels of care in a timely and effective manner. - Completes Transition Evaluations and collects Social Determinants of Health (SDOH) data on patients within 48 hours of identification and begins discharge planning. - Assesses and interviews patient and caregivers as part of this evaluation and as needed. - Identifies community resources and service needs and facilitates appropriate referrals as needed, while also providing education to patients, caregivers, and the multidisciplinary team regarding the available post-acute care services and needs. - Assists with referrals for community resources and service needs including housing, food, transportation, and other social and environmental issues affecting health. - Serves as a content expert regarding payor information. - Educates the multidisciplinary team, patients and caregivers regarding payor requirements and barriers. - Communicates with payors as needed to coordinate care. - Responsible for compliance with documentation guidelines and regulatory agency requirements. - Complies with all documentation requirements and documents all activities in the electronic health record. - Adheres to compliance requirements for delivery of various documents (e.g. HINN, IMM, MOON letters). - Has a working knowledge of the following documents: Advanced Directives, Medical Power of Attorney, Application forTemporary Mental Health Treatment, and out-of-hospital Do Not Resuscitate.Additional perks of being a Texas Health Care Transition Nurse - Benefits include 401k, PTO, medical, dental, Paid Parental Leave, flexible spending, tuition reimbursement, student Loan repayment program, as well as several other benefits. - A supportive, team environment with outstanding opportunities for growth. - Explore our Texas Health careers site (https://jobs.texashealth.org/) for info like Benefits (https://jobs.texashealth.org/benefits) , Job Listings by Category (https://jobs.texashealth.org/professions) , recent Awards (https://jobs.texashealth.org/awards) we've won and more.Do you still have questions or concerns? Feel free to email your questions to recruitment@texashealth.org .#LI-JH1Texas Health requires a resume when an application is submitted.Employment opportunities are only reflective of wholly owned Texas Health Resources entities.We are an Equal Opportunity Employer and do not discriminate against any employees or applicant for employment because of race, color, sex, age, national origin, religion, sexual orientation, gender identity, status as a veteran, and basis of disability or any other federal, state or local protected class. More...

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