8 Hospitals jobs in Alamo

No Dialysis Experience Needed

Paid Training in Dialysis

Excellent Benefits

No Dialysis Experience Needed

Paid Training in Dialysis

Excellent Benefits

PURPOSE AND SCOPE:

Functionsas part of the Inpatient Services Hemodialysis Health Care team in providing safe and effective dialysis therapy for assigned patients inaccordance with FMCNA policies, procedures, and training and in compliance with regulations set forth by the corporation, state, and federalagencies.

PRINCIPAL DUTIES AND RESPONSIBILITIES:

Providespatient care under the directsupervision of Hemodialysis Registered Nurse for assignedpatient(s) in the dialysissuite in the acutesetting; excluding Intensive Care Units.

• Responsible for reporting and documenting all new and unusual incidents, information, complaints, or problems to the RN.
• Promotes andassists in themaintenance of a safe and cleanworking environment. Supportsthe FMCNA commitment to the Quality Enhancement Program (QEP) and Quality Assessment and Performance Improvement (QAI) Activities; including those related to patientsatisfaction and actively participates in process improvement activities that enhance the likelihood that patients will achievethe FKC Quality Enhancement Goals (QEP).
• With documented competency and proficiency may set up and prime equipment as directed by the FreseniusNurse for renal replacement therapies(hemodialysis, continuous renal replacement and peritoneal dialysis therapies).
• Will be responsible for assuring the dialysis machine hasbeen set up, tested and found to be safe fordialysis treatment in accordance with manufacturer instructions for use and company policy and procedures.
• Welcomes assignedpatients and inquires as to their well-being since their last treatment. Reports any complaints or observations to the FMCNA RN.
• Obtains necessary pre and post treatment vital signs and weight. Reportsunusual findingsto FMCNA RN.
• Reports any difficulties in cannulation to FMCNA RN as permitted by state requirements; or unusual findings to FMCNA RN.
• Responsible for accuratedocumentation of information related to the patienttreatment. This information is documented appropriately in the individual patient record to include the hospital Electronic Medical System (EMS) and the Acute Care Electronic System (ACES).
• Responsible for calculating and entry of individual patients'dialysis machineprogramming for Ultrafiltration (UF) goal; treatmenttime; Sodium (Na) modeling; and UF modeling as prescribed.
• Responsible for ensuringappropriate safety alarmsare enabled including narrowvenous limits (NVL 160).
• Collects, labels specimens and ensurestimely delivery to laboratory per facilitypolicy.
• Evaluates intradialytic problemsand provides intervention as prescribedby physician's order or as directedby FMCNA RN. Monitorspatient's responseto dialysis therapyand report any unusual findingsto FMCNA RN.
• Obtains vital signs prior to reinfusion; performing all relevant functionsnecessary for the discontinuation of treatment- documentation.
• Reports any change or unusual findingsto FMCNA RN.
• Evaluates patient prior to termination of venousaccess - standing and sitting blood pressures prior to termination of venousaccess. Obtains hemostasis and appliesappropriate dressings. Evaluates the patientprior to dischargeand reports any unusualfindings to the FMCNA RN
• Review and comply with the Code of Business Conduct and all applicable company policies and procedures, local, state and federal laws and regulations.
• Assist with various projectsas assigned by direct supervisor or supervising RN.
• Other duties as assigned.

Additional responsibilities may include focuson one or moredepartments or locations. See applicable addendum for department or locationspecific functions.

PHYSICAL DEMANDS AND WORKING CONDITIONS:

• The physical demands and work environment characteristics described here are representative of those an employee encounters while performing the essential functionsof this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

• Day-to-day work includes personalcomputer work while standingand sitting, interaction with patients, facility staff and physicians.

• The position requires travel between assignedfacilities and variouslocations within the community.

• The work environment is characteristic of a healthcare facility with air temperature control and moderatenoise levels.

• May be exposedto infectious and contagious diseases/materials.

• The position providesdirect patient care that regularlyinvolves heavy liftingand moving of patients, and assisting with ambulation. Equipment aids and/or coworkers may provideassistance.

• This position requires frequent,prolonged periodsof standing and the employee must be able to bend over. The employeemay occasionally be required to assist in moving machinesand equipment of up to 200 lbs., and may lift chemicaland water solutions of up to 30 lbs. up as high as 5 feet.

• There is a two-person assist program and material assist devices for the heavier items.

EDUCATION:

• High School Diploma required

EXPERIENCE AND REQUIRED SKILLS:

• None required. At least 6 months' experience is preferred in relatedField (EMT, SurgicalTechnicians, Army, Phlebotomists, and technicians).

• Must obtain CCHT within 18 monthsof hire.

• Effective communication skills - both verbaland written.

• Employees are required to take the Ishihara's ColorBlindness test as a conditionof employment. Note that: Failing the Ishihara Test for Color Blindnessdoes not preclude employment. The Company will consider whetherreasonable accommodations can be made.

Fresenius Medical Care maintains a drug-free workplace in accordance with applicable federal and state laws.

What you'll be doing

Patient care. You will work directly with patients to provide safe, comfortable, and high-quality dialysis treatment. Responsibilities include gathering patient stats before and after treatment, initiating treatment, monitoring patients during treatment, terminating treatment, and collecting patient blood samples per physician orders.

Technician Duties. You will ensure quality comes first by preparing machines for hemodialysis treatments, cleaning and disinfecting machines after treatment, and conducting machine safety checks and logging results for quality control, ensuring all protocols and regulations are followed.

Safety and Quality. You will use appropriate safety measures, including personal protective equipment. Working under the supervision of a Charge Nurse, you will adhere to all company policies, procedures, and state/federal laws and regulations. You will participate in all required staff meetings and continuing education offerings.

PATIENT CARE TECHNICIAN
STATE SPECIFIC BOARD OF NURSING REQUIREMENTS

California

• Must possess current Certified Hemodialysis Technician (CHT) certificate from California Department of Public Health (CDPH) at time of hire OR
• Hired at USRC location recognized by state of California as an approved dialysis technician training program and obtain California state certification (CHT) within six (6) weeks of successful completion of training program.

• Must possess current Certified Nursing Assistants -- Dialysis Technicians (CNA-DT) certificate from Maryland Board of Nursing OR
• Hired at USRC location recognized by state of Maryland as an approved dialysis technician training program and obtain Maryland CNA-DT certificate within three (3) months from date of hire OR
• Out-of-state applicant must have active BONENT certification and provide proof of initial application for CNA-DT certification.

• Must have New Mexico dialysis technician certificate at time of hire OR
• Hired at USRC location recognized by state of New Mexico as an approved dialysis technician training program and obtain New Mexico state certification within six (6) months of successful completion of training program OR
• New Mexico certification of hemodialysis technician is required for out of state applicant with active state or national hemodialysis certification; must obtain New Mexico state certification prior to working as a Certified Hemodialysis Technician.
• After January 1 st , 2024, all initial applications for the certified hemodialysis technician will require a national hemodialysis technician certificate.
• The applicant must submit proof of a valid national hemodialysis technician certificate from a recognized organization.
• Hemodialysis technician students must have a current basic life support credential prior to and while the student has contact with patients

• Must have Ohio dialysis technician intern certificate at time of hire OR
• Hired at USRC location recognized by state of Ohio as an approved dialysis technician training program and submit application for Ohio dialysis technician intern certificate to board no later than four (4) weeks prior to completion of the approved training program.
• Must obtain Ohio Board of Nursing Certificate (OCDT) not less than twelve (12) months and not later than eighteen (18) months of enrolling in the USRC OCDT program.

• Must possess current Certified Hemodialysis Technician (CHDT) certificate from Oregon Public Health Division at time of hire OR
• Must obtain Oregon dialysis technician provisional certificate within three (3) weeks of successful completion of training program and obtain Certified Hemodialysis Technician (CHDT) certificate from Oregon Public Health Division within eighteen (18) months. An Oregon Provisional Certification is valid for six months and can be renewed for one additional six month period.

DHR Health - US:TX:Edinburg - Varies

Summary:

POSITION SUMMARY:

Coordinates all admissions including interfacility transfers, and screens for appropriateness of admissions - targeting specific admission criteria requirements and medical necessity for admission. Utilizes Interqual-screening criteria for all admissions and observation status patients. Obtains physicians orders prior to admission. Utilizes Interqual Criteria for screening transfers into the facility. Must possess a thorough knowledge of hospital 3rd party reimbursement rules and regulations. Assists in the identification of appropriate utilization of resources across the continuum of care.

Works collaboratively with interdisciplinary staff internal and external to the organization, and participates in quality improvement and evaluation processes related to the management of patient care.

POSITION EDUCATION/ QUALIFICATIONS :
• Licensed Register Nurse is required.
• Current license/valid permit to practice in the State of Texas will be required of all certified individuals.
• Candidate must demonstrate proficiency in both the English and Spanish language.

JOB KNOWLEDGE/EXPERIENCE :
• Knowledge in the areas of case management and utilization management, experience with Managed Care and utilization management as it relates to third-party payers preferred.
• Three to five years clinical experience is required, with experience in a Hospital or acute care setting being strongly preferred
• Experience in use of InterQual and or Milliman criteria and review processes highly desirable.
• Knowledge and understanding of Medicare and Medicaid guidelines and regulations pertaining to utilization review and discharge planning.

Responsibilities:

POSITION RESPONSIBILITES:

1. Assists in the development and implementation of the case management program.
• Collaborates with already existing programs and departments to ensure appropriate resource utilization by all patients being followed in a caseload.
• Works with nurse managers, other clinical departments, and division directors in program development.
• Establishes and/or attempts appropriate caregiver forums to provide program teaching/information and seeks program effectiveness feedback.
• Provides orientation and ongoing education specific to case management.
• Participates in extending case management approach.
• Acts as a consultant to all disciplines specific to case management program.
• Performs ongoing evaluation of case management program.

Meets Criteria :
• Participates in daily rounds, providing education to other team members
• Provides follow-up to system issues and reports individual practitioner variances appropriately to PA or Department Director.
• Participates in respective nursing unit meetings.

2. Directs, coordinates, and provides case management to patients in caseload.
• Assesses the patients within the caseload to identify needs, issues, resources, and care goals.
• Through proper reporting mechanisms, completes case management assessment, reviews admitting diagnoses/problem(s), determines plan to address client's needs, and optional/preferred level of care. Develops a discharge plan early on in admission.
• Implements and coordinates interventions that will lead to goals in plan.
• Monitors the effectiveness of the plan.
• Participates in case finding and preadmission evaluation screening to ensure reimbursement.
• Identifies potential transition planning problems in a timely manner to set up services required.
• Works with attending physician and care team members to move patient through the hospital system and set up appropriate services or referrals.
• Identifies need for new resources if gaps exist in service continuum and initiates creative care delivery options.
• Daily responsibilities:
• Reviews the medical records of all observation and inpatient admissions to determine the medical necessity for admission and continued stay, using pre-established criteria (InterQual or Milliman) with appropriate frequency and Obtain physician's orders if necessary.
• Continues review of all patients using criteria and determines need for continued hospitalization based upon third party payer/insurance guidelines.
• Assesses clinical, including psychosocial, system parameters.
• Establishes planning to determine goals and objectives and care setting to optimally meet patient needs. Develops a discharge plan in a timely manner.
• Conducts necessary conferences and team meetings regarding specific patient needs.
• Implements interventions that lead to the patient accomplishing goals established in plan.
• Coordinates the necessary resources to accomplish goals developed in plan.
• Proactively affects system to facilitate efficient flow of care.
• Gathers information from sources to enable case manager to monitor the plan's effectiveness.
• Evaluates the effectiveness of the plan (including variance) in reaching patient's outcomes and goals.
• Makes appropriate changes to plan as necessary.
• Coordinate interfacility transfer request as per policy.
• Meets Criteria:
• a. Documents patient/patient representative understanding of case management plan.
• b. Documents avoidable day and /or delay in service variances as per policy.
• c. Recognizes and immediately intervenes in cases of suspected abuse or neglect.
• d. Recognizes National Patient Safety Goals and Core Measures as applicable to the patient populations served.

3. Plays an essential role in assisting physicians, nurses, and staff with an accurate determination of a patient's observation status. The case manager is an important resource in preventing delayed discharges of observation patients.
• Identifies and monitors observation admissions daily, to determine the correct patient status.
• Consults with physicians, nursing, admitting, and outside insurance case managers to determine the appropriate status of patient.
• Assumes the role of review coordinator for observation services; reviews medical record for appropriateness of status and level of care and facilitates the level of care, utilizing InterQual or Milliman for observation.
• Works with physicians, nurses, staff, patients, and families to arrange prompt and safe discharge.
• Must take telephone orders from physicians changing patient status from observation to inpatient admission. This should be done when monitoring observation status. A call or page should be made to a physician if the case manager believes that this should be an inpatient admission and should not wait until the 24 hours are ending before conversion. Case managers must actively monitor patients on observation status and seek to clarify their status as close to the 24-hour benchmark as possible.
• Develops a discharge plan with nursing when appropriate.

Meets Criteria:
• Accurately applies InterQual or Milliman criteria 95% of the time in determining status. Refers appropriately to the PA when medical decision making determination is necessary.
• Consistently follows Condition Code 44 policy when IP status requires changing to Observation for Medicare patients 95% of the time.
• Consistently follows the Observation policy for all other payers. (correct determination of start time)

4. Reviews the medical records of all inpatient admissions to determine the medical necessity for admission and continued stay, using pre-established criteria.
• Identifies cases that fail daily to meet criteria and refers these cases to appropriate physician advisor.
• Assists and educates attending physicians on an on-going basis.
• Contacts the attending physicians daily on cases that lack adequate documentation warranting acute hospitalization.
• Contacts the attending physician to notify him or her of the decision to issue notice of non-coverage. Explains UR process and insurance coverage requirements. Obtains physician's written concurrence when necessary.
• Informs the patient and/or next of kin when insurance coverage must be terminated for the current admission. Issues HINN letter.
• Reinstates insurance coverage when the patient's condition becomes acute and meets criteria again. Issues reinstatement letter.
• Continues review of all patients using criteria and determines need for continued hospitalization based upon third party payer/insurance guidelines.

Meets criteria:
• The initial review applying InterQual criteria is completed within 24 hours of admission.
• Continued Stay Review is completed no greater than every 48 hours (72 hours for Critical Care) or more frequently as dictated by discharge screening criteria.
• Document timeframe for next review 95% of the time.
• Proceeds to issue Hospital Issued Notice of Non-coverage and Hospital Requested Review for Medicare patients according to policy.
• Refers cases not meeting criteria appropriately, following contract requirements for all other payers.

5. Collaborates with Quality Management Department: Performs quality assessment reviews and studies both concurrently and retrospectively as required by the hospital's PI plan, JCAHO standards, and third-party payer regulations.
• Applies generic quality screens/indicators concurrently to patient medical records and accurately abstracts relevant patient care data to determine if quality screens are flagged. Performs first line reviews on potential quality issues as requested by director.
• Refers all other potential quality of care issues identified, not reviewed, as part of the quality assessment screening to the physician advisor to facilitate timely follow up.

Meets Criteria:
• Collects potentially avoidable day data for system Performance Improvement.
• Refers potentially avoidable day cases to the PA when the medical staff triggers are met.
• Refers quality issues to the Case Management Supervisor, CMO and/or PA appropriately.

6. Provides clinical data/information to contracted third-party payers while patient is hospitalized to ensure continued reimbursement and to avoid reimbursement delays within 24 hours of request.

Meets Criteria:
• a. Accurate InterQual and Milliman documentation that meet the requirements of third party payers for admission certification and continued stay approval is documented 95% of the time.

7. Interacts, communicates, and intervenes with multidisciplinary healthcare team in a purposeful, goal-directed fashion. Works proactively to maximize the effectiveness of resource utilization.
• Anticipates, initiates, and facilitates problem resolution around issues of resource use and continued hospitalization and discharge planning.
• Establishes a means of communicating and collaborating with physicians, other team members, the patient's payers, and administrators.
• Utilizes appropriate resources in cases that present ethical dilemmas.
• Explores strategies to reduce length of stay and resource consumption within the care-managed patient populations, implements them, and documents the results.
• Communicates to appropriate members of healthcare team the patients at risk of losing insurance coverage or HINN notification of Medicare and Medicaid patients.
• Maintains a proactive role to ensure appropriate documentation concurrently to minimize inefficient resource utilization and prevent loss of reimbursement.
• Reviews physician documentation and, when needed, follows procedures to seek clarification of documentation relative to diagnosis and comment, on the patient's clinical state.

Meets Criteria:
• Participates in daily rounds on nursing units.
• Refers to PA those cases in which appropriate resource utilization is to be evaluated, such as IP MRI, IP endoscopy, or whenever the test ordered does not relate to the reason for admission or diagnosis/symptom does not meet IP criteria.
• Age of Patient Populations Served depending on assignment
• (check all that apply)
• __X___ Neonates 1 - 30 days ___ No patient contact
• __X___ Infants 30 days - 1yr.
• __X___ Children 1 - 12 yrs.
• __X___ Adolescents 13 - 18 yrs.
• __X___ Adults 19 - 70 yrs.
• __X___ Geriatrics 70+

Other information:

LINES OF REPSONSIBILITES :

(Chain-of-command)

1. (Director)

CUSTOMER SERVICE:

Provide excellent customer service to all DHR customers. All employees are required to attend the DHR C.A.R.E.S program which outlines the Customer Service Principals including: Commitment, Accountability, Respect, Excellence and Service.

AGE SPECIFIC :

Employees must be able to demonstrate the knowledge and skills necessary to provide care appropriate to the age of the patients served in his/her assigned unit. The individual must demonstrate knowledge of principles of growth and development over the life span and possess the ability to assess data reflective of the patient's status and interpret the appropriate information needed to identify each patient's requirement relative to his or her age.

AMERICANS WITH DISABILITIES ACT: (ADA) :

A. Essential Duties : Indicated by bold print within performance standards, preceding individual numbered criteria.

The following table provides physical requirements that will be associated with, but not limited to, this position:
• Light/moderate lifting up to 20 lbs, from the floor to shoulder height.
• Yes
• Kneeling
• Yes
• Must be able to assist other employees with lifting more than 20 lbs.
• Yes
• Walking
• Yes
• Light/moderate carrying up to 20 lbs.
• Yes
• Standing/Squatting
• Yes
• Straight pulling
• Yes
• Sitting
• Yes
• Pulling hand over hand
• Yes
• Pushing
• Yes
• Repeated bending
• Yes
• Stooping/Bending
• Yes
• Reaching above shoulder
• Yes
• Climbing Stairs
• Yes
• Simple grasping
• Yes
• Climbing Ladders
• No
• Dual simultaneous grasping
• Yes
• Depth Perceptions needed
• Yes
• Ability to see
• Yes
• Identify Colors
• Yes
• Operating office equipment
• Yes
• Twisting
• Yes
• Operating mechanical equipment
• Yes
• Crawling
• No
• Ability to read and write
• Yes
• Ability to Count
• Yes
• Ability to hear verbal communication without aid
• Yes
• Operating Personal Vehicle
• Yes
• Ability to comprehend written/verbal communication
• Yes
• Other: Ability to deal with stress
• Yes
• OSHA Category
• III
•
•B. Working Conditions: The individual spends over 95% of his/her time in an air-conditioned environment with varying exposures to noise. There is protection from weather conditions but not necessarily from temperature changes. The position does have low exposure to malodorous, infectious body fluids from patients and some minimal exposure to noxious smells from cleansing agents.

C. Occupational Exposure: This position has minimal to no exposure to blood, body fluids, or tissues and is an OSHA Category III (although situations can be imagined or hypothesized under which anyone, anywhere, might encounter potential exposure to body fluids). Person who performs these duties are not called upon as part of their employment to perform or assist in emergency medical care or first aid or to be potentially exposed in some other way.

D. Aptitudes: HIGH 1 2 3 4 5 6 LOW

Intelligence: General learning ability: The ability to "catch on" or understand instructions and underlying principles. Ability to reason and make judgments. 3

Verbal: Ability to understand meanings of words and ideas associated with them, and to use them effectively. To comprehend language, to understand relationships between words, and to understand meanings of whole sentences and paragraphs. To present information or ideas clearly. 3

Numerical: Ability to perform arithmetic operations quickly and accurately. 2

Spatial: Ability to comprehend forms in space and understands relationships of plane and solid objects. Frequently described as the ability to "visualize" objects or two or three dimensions, or to think visually of geometric forms. 2

Form Perception: Ability to perceive pertinent details and objects or in pictorial or graphic material to make visual comparisons and discriminations and see slight differences in shapes and shadings of figures and widths and lengths of lines. 3

Clerical Perception: Ability to receive pertinent details and verbal or tabular material. To observe differences in copy, to proofread words and numbers, and to avoid perceptual errors in arithmetic computation. 2

Motor Coordination: Ability to coordinate eyes and hands to fingers rapidly and accurately in making precise movements with speed. Ability to make a movement response accurately and quickly. 3

Finger Dexterity: Ability to move hands easily and skillfully. To work with fingers in placing and turning motions. 3

Manual Dexterity: Ability to move hands easily and skillfully. To work with hands in placing and turning motions. 3

Eye-Hand-Foot Coordination: Ability to move the hand and foot coordinately with each other in accordance with visual stimuli. 3

Color Discrimination: Ability to perceive and respond to similarities or differences in colors, shapes, or other values of the same or different color. To identify a particular color, or to recognize harmonious or contrasting color combinations, or to match color adequately. 3

I have read and reviewed my job description with my supervisor or designee and I understand the job I am expected to perform.

If applicable ___ certification will be completed within ___ time frame of hire/transfer date.

Employee Signature: ___ Date: ___

Transfer/Hire Date Effective: ___.