**All the benefits and perks you need for you and your family:** - Benefits from Day One - Paid Days Off from Day One - Student Loan Repayment Program - Career Development - Whole Person Wellbeing Resources - Mental Health Resources and Support - Debt-free Education (Certifications and Degrees without out-of-pocket tuition expense) - Nursing Clinical Ladder Program **Our promise to you:** Joining Texas Health Huguley - AdventHealth is about being part of something bigger. It’s about belonging to a community that believes in the wholeness of each person, and serves to uplift others in body, mind and spirit. Texas Health Huguley - AdventHealth is a place where you can thrive professionally, and grow spiritually, by Extending the Healing Ministry of Christ. Where you will be valued for who you are and the unique experiences you bring to our purpose-minded team. All while understanding that **together** we are even better. **Texas Health Huguley- operates as a joint venture between Texas Health Resources and AdventHealth.** **Schedule:** **Full-Time** **Shift:** **Friday, Saturday, Sunday (7:00am – 7:00pm)** **Location:** 11801 South Fwy., Burleson, TX 76028 **The community you’ll be caring for:** + Our care for patients extend to the spiritual level by praying with patients and families and providing on call, 24 hours, 7 days a week Chaplains for spiritual support. + Award winning facility and departments including “Great Place to Work” by Becker’s Hospital Review and Gallup. + Work with the latest technology and top experts including “Daisy Award” recipients while on our journey to Magnet status and Pathways designated. + Designated Emergency Center of Excellence recognizing our facility as a high-performing emergency department + Located about 10 minutes from downtown Fort Worth and near TCU in the award-winning school district, Burleson ISD which also provides a low-cost of living. **The role you’ll contribute:** The RN Care Manager in collaboration with the patient/family, social workers, nurses, physicians and the interdisciplinary team, ensures patient-centered care coordination and progression through the continuum of care. The RN Care Manager ensures efficient and cost-effective care through appropriate resources monitoring, and clinical care escalations. The RN Care Manager is under the general supervision of the Care Management Supervisor or Manager and is responsible for patient evaluations of post-hospital needs; development of a transition of care plans and initiation of the implementation of the transitions of care plans prior to the discharge of the patient. The RN Care Manager is responsible for optimal patient flow/throughput to enhance continuity of care, smooth and safe transitions, patient satisfaction, patient safety, readmission prevention and length of stay management. The RN Care Manager communicates daily with the interdisciplinary team during daily multidisciplinary rounds. Care coordination, discharge planning, transitions of care planning and understanding of medical necessity are core competencies of this role. The RN Care Manager facilitates the collaborative management of patient care across the continuum, intervening to remove barriers to timely and efficient care delivery and reimbursement. The RN Care Manager provides education to nurses, physicians and the interdisciplinary team on issues related to utilization of resources, medical necessity, CMS CoP for Discharge Planning and care coordination. The RN Care Manager is knowledgeable of post-hospital care and services available to the patient including, but not limited to the following: Home Health, Infusion Services, Durable Medical Equipment, Palliative Care, Hospice, Outpatient Services, Transitions of Care Clinics, Transitional Care supportive programs and clinics, follow up appointments, Skilled Nursing Facilities, Rehabilitation Services and Facilities and Community-based Organizations. The RN Care Manager adheres to departmental and system goals, objectives, policies and procedures and ensures quality patient care and regulatory compliance. Actively participates in outstanding customer service and accepts responsibility in maintaining relationships that are equally respectful to all. **The value you’ll bring to the team:** · Completes Initial Evaluation for transition of care needs on all identified patients within one calendar day of admission and documents according to policies and procedures. Interviews patient and involved care givers (as permitted by the patient) as well as a review of the current and past inpatient and outpatient medical record in the Initial Evaluation. · Reviews necessary patient information including labs, medications (Pre and post hospital), History and Physical, Therapy notes, ED notes, test results and progress notes. · Incorporates the patient/family care goals and preferences as much as possible into the transition of care planning and communicates these goals and preferences to the multidisciplinary team. · Incorporate clinical, social and financial factors into the transition of care plan. · Meets with patient/families to discuss realistic and appropriate discharge options and providers of post-hospital care. · Incorporates social determinants of health into transitions of care planning and applies risk mitigation interventions to meet the individual needs of each patient · Identifies and collaborates with the interdisciplinary team and hospital operations to resolve potential barriers to transition of care plan achievement. · Collaborates with the multidisciplinary healthcare team daily in multidisciplinary rounds to efficiently communicate and facilitate high quality patient progression of care and transitions plans. Qualifications **The expertise and experiences you’ll need to succeed:** **EDUCATION AND EXPERIENCE REQUIRED:** · Associates Degree Nursing or RN Diploma degree · Registered Nurse (RN) in Texas · Two (2) years of medical/hospital nursing experience **EDUCATION AND EXPERIENCE PREFERRED:** · BSN · Health-related Master's degree or MSN · Prior Care Management/Utilization Management This facility is an equal opportunity employer and complies with federal, state and local anti-discrimination laws, regulations and ordinances. The salary range reflects the anticipated base pay range for this position. Individual compensation is determined based on skills, experience and other relevant factors within this pay range. The minimums and maximums for each position may vary based on geographical location. **Category:** Case Management **Organization:** Texas Health Huguley Hospital **Schedule:** Full-time **Shift:** 1 - Day **Req ID:** 24039620 We are an equal opportunity employer and do not tolerate discrimination based on race, color, creed, religion, national origin, sex, marital status, age or disability/handicap with respect to recruitment, selection, placement, promotion, wages, benefits and other terms and conditions of employment.