ED Throughput & Care Coordination Lead

CHRISTUS Health; New Braunfels (TX); On-site; USD 75,000 - 95,000; Full time

Job summary

CHRISTUS Health in Texas is seeking an Emergency Department (ED) Care Manager to coordinate patient flow, assessment, and discharge planning to ensure the patient receives the most appropriate level of care.

You will collaborate with physicians, nurses, social workers, and community partners, provide patient education, and initiate referrals and prior authorizations as indicated to optimize outcomes for ED patients.

Qualifications

• 3+ years of clinical case/care management experience in the acute care setting.
• Familiarity with evidence-based medical necessity criteria sets.
• Competency in prior authorization functions and software, including the application of criteria and timelines.
• Proficiency in medical and managed care terminology.

Responsibilities

• Meets expectations of the applicable OneCHRISTUS Competencies: Leader of Self, Leader of Others, or Leader of Leaders.
• Educates ED physicians and nurses about medical necessity and admission criteria.
• Collaborates with physicians and other members of the treatment team on documentation needs and opportunities.
• Utilizes high-risk screening criteria to make appropriate community and post-ED referrals.
• Initiates prior authorization process when indicated for post-ED referrals and services.
• Plans for discharges from the ED for patients who do not require admission to include arranging for Home Health, DME, placement, and community resources.
• Coordinates and facilitates patient progression throughout the continuum.
• Intervenes with physicians and ancillary departments concerning clinical and utilization issues to ensure optimal patient outcomes.

Skills

Care coordination

Interdisciplinary collaboration

Patient education

Education

BSN

MSW

Tools

Prior authorization software

Job description

CHRISTUS Health in Texas is seeking an Emergency Department (ED) Care Manager to coordinate patient flow, assessment, and discharge planning to ensure the patient receives the most appropriate level of care.

You will collaborate with physicians, nurses, social workers, and community partners, provide patient education, and initiate referrals and prior authorizations as indicated to optimize outcomes for ED patients.