Hospital/Facility: Tenet Healthcare
Location: Dallas, TX
Tenet’s Performance Management and Innovation (PMI) Department is an internal consulting group within Tenet that is focused on improving cost efficiency and patient throughput throughout Tenet. The PMI team is comprised of experts in Nursing, Perioperative, ED, Imaging, Case Management, Labor Productivity, and both Clinical and Financial Analysts.
The PMI team works collaboratively with Tenet Hospitals to ensure implementation and benefit realization from the Medicare Performance Initiative (MPI) and other Performance Management and Innovation (PMI) engagements with respect to sustainability and repeatability of the Medicare Performance Initiative (MPI) including: (a) tracking, monitoring and assisting as needed with sustainability of Wave 1 MS-DRGs after the initial PMI rollout team transitions out; (b) ensuring repeatability and execution of Wave 2 and future Waves of MS-DRGs, including assisting with data access, assisting hospitals and regions with monitoring and tracking of work plans and scorecards, reviewing/setting targets, and on-site support as needed, intervening with hospitals and elevating progress concerns to Region as needed. Team members also monitor and track scorecard performance and implementation progress relative to other PMI engagements, including ED, Imaging and Case Management.
The Senior Case Management Specialists for Performance Management and Innovation (PMI) provide oversight for implementation of the Tenet Case Management Program in all Tenet hospitals to proactively merge the clinical, operational, and financial aspects of patient care, focusing primarily on providing an effective and efficient program to balance both quality outcomes and cost. These Senior Specialists partner with the hospital Administrative Teams in each of Tenet’s four regions, which include Florida, California, the Southern States, and the Central States/Texas Region.
Senior Case Management Specialists have responsibility for defining case management for hospital leaders and staff, as well as clarification of requirements and processes for hospital Administrative Teams and Senior Management of Tenet Healthcare Corporation. The Specialists’ responsibilities include, but are not limited to the a) development and revision of policies and procedures to maintain compliance with federal, state and accreditation agencies; b) development and delivery of educational offerings; c) conduction of onsite assessments and process improvement projects; d) development, support and monitoring of prescriptive action plans; and e) function as primary internal consultants to corporate and hospital leadership and staff.
The Case Management Specialist, PMI, travels approximately 80-90 percent of the time working both in hospital and office environments.
A current RN license and Bachelor’s degree in Nursing are required, with an advanced degree in Business and/or Health Care Management strongly preferred. At least eight to ten years of clinical experience and eight to ten years of case management and case management administration experience are required. Three to five years of general management experience and tenure in a consulting firm is highly desirable.
The successful candidate must possess diverse knowledge in clinical, financial and compliance areas, with the ability to incorporate this knowledge into operational performance improvements. He or she will take the lead in complying with regulatory standards, rules and laws, should have extensive comprehension of Medicare, Medicaid, and insurance guidelines, and solid understanding of reimbursement methodologies. Also important in this role is a working knowledge of InterQual for medical necessity and appropriateness of care. Strong analytical and problem solving skills are a must, as are advanced PC skills including Word, Excel, PowerPoint and Outlook.
Please apply: email@example.com