Qureos Mentor

Gila River Health Care

<div>Summary :
The Case Manager will provide comprehensive Case Management for patients as assigned to include, but not limited to: assessing patient&rsquo;s needs; developing, implementing, monitoring, and documenting the progress of the patient throughout their hospitalization in an outside area hospital to meet their care needs prior to discharge. The intensity of Case Management is situational and appropriately based on patient need. This position is accountable for the quality of clinical services provided by both them and others and identifies barriers which may hinder effective patient care. The Case Manager performs Utilization Review of the medical necessity and appropriateness of care using InterQual criteria of patients admitted to Gila River Health Care inpatient unit: assessing patient admissions and continued stay criteria to identify issues that may delay patient discharge and facilitate resolution of these issues. 
 
Critical Tasks:
<ul><li>Demonstrates a culture of kindness through all interactions whether verbal or non-verbal with all GRHC staff members, partner facilities staff and vendors.
</li></ul><ul><li>Manages and oversees assigned patient case load to ensure delivery of all covered services identified for continuity of care across all levels of care and involved providers to achieve the optimal clinical, financial, operational, and patient satisfaction outcomes.
</li></ul><ul><li>Maintains HIPAA standards of patient confidentiality during all interactions whether written, verbal, or electronic.
</li></ul><ul><li>Establishes and promotes a collaborative relationship with members of the healthcare team within GRHC and outside facility partners.
</li></ul><ul><li>Serves as Case Manager between referral hospitals, treatment facilities and patients/patient&rsquo;s families to ensure delivery of effective and appropriate assistance and follow-up for returning to pre/post hospitalization status/care.
</li></ul><ul><li>Reviews charts of assigned patients to determine appropriate referral services based on assessed patient needs.
</li></ul><ul><li>Facilitates, schedules and/or participates in a variety of patient Case Management activities to ensure patient and/or family personal and health care needs are met in a timely manner; proactively identifies alternative resources as needed.
</li></ul><ul><li>Participates in &ldquo;on-call&rdquo; for Case Management Department and Utilization Review
</li></ul><ul><li>Performs Utilization Review of patient chart to ensure compliance with established InterQual criteria to maximize reimbursement/coverage of charges.
</li></ul><ul><li>Evaluates inpatient medical necessity and appropriateness of care utilizing InterQual criteria, for optimizing outcomes.
</li></ul><ul><li>Assesses patient admissions and continued stay to identify issues that may delay patient discharge and communicates to the interdisciplinary team while facilitating a resolution.
</li></ul><ul><li>Collects and communicates pertinent, timely information to the health care team to fulfill utilization and regulatory requirements.
</li></ul><ul><li>Collaborates with patient, family members, and other involved parties to ensure care coverage through private and governmental health care plans.
</li></ul><ul><li>Collects outcome data to be used in identifying best practices and targeting performance improvement solutions.
</li></ul><ul><li>Participates in departmental orientation, on the job training, and quality assurance programs/initiatives.
</li></ul><ul><li>Receives and responds to patient concerns; research issues for corrective action as appropriate based on findings; escalates physician/provider concerns to appropriate parties and identifies alternative solutions.
</li></ul><ul><li>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.
</li></ul><ul><li>Participates in Community Events representing GRHC and Case Management Department with ability to educate on departmental functions.
</li></ul><ul><li>Other duties as assigned by Case Management Director/Manager
</li></ul><ul><li>Establishes goals and objectives for the department that meet or exceed GRHC&rsquo;s Code of Ethics and Standards for Conduct Policy.
</li></ul><ul><li>Is familiar and remains current on safety and emergency management process for the department.
</li></ul>Required Qualifications:
<ul><li>Current State of Arizona or Compact State Registered Nurse license, BSN preferred.
</li></ul><ul><li>Current CPR for Healthcare professional's certification
</li></ul><ul><li>Must have at least 1-year previous case management experience, CCM certification preferred but must obtain within 2 years of hire.
</li></ul><ul><li>Experience must include working in an acute care and/or home care setting for at least a 12-month period.
</li></ul><ul><li>Native American population preferred.
</li></ul><ul><li>Must have a working knowledge of Case Management, acute care and/or home care environments, community resources and resource/utilization management.
</li></ul><ul><li>Case Management Specialty Area Requirements :
<ul><li>Pediatrics Case Manager &ndash; Must have at least 1 year Pediatrics experience
</li><li>Cancer Case Manager &ndash; Must have at least 1 year oncology/hospice/or cancer case management experience
</li><li>Pain Management Case Manager &ndash; Must have at least 1 year experience working with pain management patients/hospice patients .
</li><li>Women&rsquo;s Health/High Risk Pregnancy Case Manager &ndash; Must have at least 1 year Women&rsquo;s Health/Pregnancy experience
</li><li>Family Medicine Case Manager &ndash; Must have at least 1 year Medical-Surgical or Family Clinic experience
</li><li>Internal Medicine Case Manager - Must have at least 1 year Medical-Surgical or Family Clinic experience
</li><li>Emergency Department/Utilization Review Case Manager &ndash; Must have 1 year Medical-Surgical experience and/or 1 year Utilization Review experience</li></ul></li></ul></div>

Case Manager-Case Management-HHK-Sacaton

<div>Position Summary: Cares for patients in hospital, nursing home, or other medical facility as well as during transportation between medical facilities under direction of nursing and medical staff, by performing the following duties personally. Responsible for ensuring that all critical tasks are fulfilled on a timely basis.
Critical Tasks:
<ul><li>Answers signal lights, bells, or intercom system to determine patients' or residents&rsquo; needs while ensuring that all such needs are fulfilled by appropriately qualified staff.
</li><li>Bathes, dresses, and undresses patients.
</li><li>Serves and collects food trays and feeds patients requiring help.
</li><li>Transports patients or assists patients to walk as well as to, from and between medical facilities as necessary.
</li><li>When transporting patients and residents, gathers any supplies necessary for care of the patient or resident while away from the original care or living facility.
</li><li>When transporting patients and residents, reports to nursing staff all medical and care information occurring during the transportation event immediately upon return to the original facility.
</li><li>Performs basic monitoring and testing functions such as blood glucose measurements and documentation.
</li><li>Drapes patients and residents for examinations and treatments and remains with patients and residents to perform such duties as holding instruments and adjusting lights.
</li><li>Turns and repositions bedfast patients, alone or with assistance, to prevent bedsores.
</li><li>Changes bed linens, runs errands, directs visitors, and answers telephone.
</li><li>Takes and records temperature, blood pressure, pulse and respiration rates, and food and fluid intake and output, as directed.
</li><li>Cares for incontinent patients very quickly while ensuring patient and resident cleanliness.
</li><li>Maintains very rapid responsiveness to all patient and resident needs and requests.
</li><li>Communicates thoroughly and in detail regarding all patient and resident subjects, both verbally and in writing.
</li><li>Cleans, sterilizes, stores, prepares, and issues dressing packs, treatment trays, and other supplies.
</li><li>Dusts and cleans patients' rooms while ensuring a positive living environment.
</li><li>Reports all material medical information and patient/resident condition changes to nurse on duty.
</li><li>Provides snacks and hydration within limits of medical orders.
</li><li>Performs all work duties efficiently and on a timely basis while serving multiple patient and resident needs on a simultaneous basis.
</li><li>Evacuates patients and residents during emergencies under the direction of nurse on duty.
</li><li>Demonstrates ability to regularly change priorities to accomplish all tasks despite frequent interruptions.
</li><li>Demonstrates ability to clearly communicate, both orally and in writing, while performing all essential functions.
</li><li>Performs other special projects and duties as assigned.
</li></ul>Required Qualifications:
<ul><li>High school diploma or GED preferred.
</li><li>Arizona State Certification/Licensure as a Nursing Assistant.
</li><li>Prior medical environment work experience is preferred.
</li><li>Current and continuing BLS training and certification.
</li><li>Employment at The Caring House requires: AZ Department of Public Safety Fingerprint Clearance Card.
</li><li>Demonstrated ability to relate to diverse cultures and specifically the Gila River Community and/or other Native American cultures and community health services.</li></ul></div>

CNA-Certified Nursing Assistant-SNF-TCH-Sacaton

Join Gila River Health Care and explore 2   exciting career opportunities. They're hiring for various roles with options for remote or on-site work. Apply today and become part of their innovative team.

Gila River Health Care

About Company

Case Manager-Case Management-HHK-Sacaton

CNA-Certified Nursing Assistant-SNF-TCH-Sacaton