Talent.com
Supplemental Case Manager

Supplemental Case Manager

Memorial Hermann Health SystemBellaire, TX, US
job_description.job_card.30_days_ago
serp_jobs.job_preview.job_type
  • serp_jobs.job_card.full_time
job_description.job_card.job_description

At Memorial Hermann, we pursue a common goal of delivering high quality, efficient care while creating exceptional experiences for every member of our community. When we say every member of our community, that includes our employees. We know that when our employees feel cared for, heard and valued, they are inspired to create moments that exceed expectations, while prioritizing safety, compassion, personalization and efficiency. If you want to advance your career and contribute to our vision of creating healthier communities, now and for generations to come, we want you to be a part of our team.

Job Summary

The purpose of the Case Manager position is to support the physician, primary medical homes, and interdisciplinary teams in facilitating patient care, with the underlying objective of enhancing the quality of clinical outcomes and patient satisfaction while managing the cost of care and providing timely and accurate information to payors. The role integrates and coordinates resource utilization management, care facilitation and discharge planning functions. In addition, the Case Manager helps drive change by identifying areas where performance improvement in needed (e.g., day to day workflow, education, process improvements, patient satisfaction). The position is responsible for coordinating a wide range of self management support and provides information to update and maintain relevant disease registry activity. Accountable for a designated patient caseload and plans effectively in order to meet patient needs across the continuum, provide family support, manage the length of stay, and promote efficient utilization of resources.

Job Description

Minimum Qualification

Education

Graduate of an accredited school of professional nursing required; Bachelors of Nursing preferred; or graduate of an accredited Masters of Social Work program (MSW); Master's degree preferred

Licenses / Certifications

  • Current and valid license to practice as a Registered Nurse in the state of Texas or
  • Current and valid license as a Master Social Worker (LMSW) in the state of Texas required, LCSW preferred
  • Certification in Case Management required within two (2) years of hire into the Case Manager position

Experience / Knowledge / Skills :

  • Three (3) years of experience in hospital-based nursing or social work
  • Experience in utilization management, case management, discharge planning or other cost / quality management program preferred
  • Excellent interpersonal communication and negotiation skills
  • Demonstrated leadership skills
  • Strong analytical, data management and PC skills
  • Current working knowledge of discharge planning, utilization management, case management, performance improvement, disease or population management and managed care reimbursement
  • Understanding of pre-acute and post-acute venues of care and post-acute community resources, physician office routines, and transitional procedures for pre and post acute care
  • Demonstrated understanding of motivational interviewing and change management
  • Strong organizational and time management skills, as evidenced by capacity to prioritize multiple tasks and role components
  • Ability to work independently and exercise sound judgment in interactions with physicians, payors, and patients and their families
  • Effective oral and written communication skills
  • Principal Accountabilities

    Coordinates / facilitates

    patient care progression throughout the continuum.

  • Works collaboratively and maintains active communication with physicians, nursing and other members of the multi-disciplinary care team to effect timely, appropriate patient care.
  • Addresses / resolves system problems impeding diagnostic or treatment progress. Proactively identifies and resolves delays and obstacles to discharge.
  • Seeks consultation from appropriate
  • disciplines / departments

    as required to expedite care and facilitate discharge.

  • Utilizes advanced conflict resolution skills as necessary to ensure timely resolution of issues.
  • Collaborates with the physician and all members of the multidisciplinary team to facilitate care for designated case load; monitors the patient's progress, intervening as necessary and appropriate to ensure that the plan of care and services provided are patient focused, high quality, efficient, and cost effective; facilitates the following on a timely basis :
  • completion and reporting diagnostic testing;
  • completion of treatment plan and discharge plan;
  • modification of plan of care, as necessary, to meet the ongoing needs of the patient;
  • communication to third party payors and other relevant information to the care team;
  • assignment of appropriate levels of care;
  • completion of all required documentation in TQ screens and patient records.
  • Documents key clinical path variances and outcomes which relate to areas of direct responsibility (e.g., discharge planning). Uses pathway data in collaboration with other disciplines to ensure effective patient management concurrently.
  • Leads the development, implementation, evaluation and revision of clinical pathways and other Case management tools as a member of the clinical resource / team. Assists in compilation of physician profile data regarding LOS, resource utilization, denied days, costs, case mix index, patient satisfaction and quality indicators (e.g., readmission rates, unplanned return to OR, etc.).
  • Acts as preceptor / mentor to new hires. Assists in development of orientation schedule and helps identify individual needs for learning.
  • Collaborates with medical staff, nursing staff, and ancillary staff to eliminate barriers to efficient delivery of care in the appropriate setting.
  • Completes Utilization Management and Quality Screening for assigned patients.
  • Applies approved clinical appropriateness criteria to monitor appropriateness of admissions and continued stays, and documents findings based on Department standards.
  • Identifies at-risk populations using approved screening tool and follows established reporting procedures.
  • Monitors LOS and ancillary resource use on an ongoing basis. Takes actions to achieve continuous improvement in both areas.
  • Refers cases and issues to Care Management Medical Director in compliance with Department procedures and follows up as indicated.
  • Communicates with Resource Center to facilitate covered day reimbursement certification for assigned patients. Discusses payor criteria and issues on a case-by-case basis with clinical staff and follows up to resolve problems with payors as needed.
  • Uses quality screens to identify potential issues and forwards information to Clinical Quality Review Department.
  • Ensures that all elements critical to the plan of care have been communicated to the patient / family and members of the healthcare team and are documented as necessary to assure continuity of care.
  • Manages all aspects of discharge planning for assigned patients.
  • Meets directly with patient / family to assess needs and develop an individualized continuing care plan in collaboration with physician.
  • Collaborates and communicates with multidisciplinary team in all phases of discharge planning process, including initial patient assessment, planning, implementation, interdisciplinary collaboration, teaching and ongoing evaluation.
  • Ensures / maintains plan consensus from patient / family, physician and payor.
  • Refers appropriate cases for social work intervention based on Department criteria.
  • Collaborates / communicates

    with external case managers.

  • Initiates and facilitates referrals through the Resource Center for home health care, hospice, medical equipment and supplies.
  • Documents relevant discharge planning information in the medical record according to Department standards.
  • Facilitates transfer to other facilities as appropriate.
  • Actively participates in clinical performance improvement activities.
  • Assists in the collection and reporting of financial indicators including case mix, LOS, cost per case, excess days, resource utilization, readmission rates, denials and appeals.
  • Uses data to drive decisions and plan / implement performance improvement strategies related to case management for assigned patients, including fiscal, clinical and patient satisfaction data.
  • Collects, analyzes and addresses variances from the plan of care / care path with physician and / or other members of the healthcare team. Uses concurrent variance data to drive practice changes and positively impact outcomes.
  • Collects delay and other data for specific performance and / or outcome indicators as determined by Director of Outcomes Management.
  • Ensures safe care to patients, staff and visitors; adheres to all Memorial Hermann policies, procedures, and standards within budgetary specifications including time management, supply management, productivity and quality of service.
  • Promotes individual professional growth and development by meeting requirements for mandatory / continuing education and skills competency; supports department-based goals which contribute to the success of the organization; serves as preceptor, mentor and resource to less experienced staff.
  • Demonstrates commitment to caring for every member of our community by creating compassionate and personalized experiences. Models Memorial Hermann's service standards by providing safe, caring, personalized and efficient experiences to patients and colleagues.
  • Other duties as assigned.
  • serp_jobs.job_alerts.create_a_job

    Case Manager • Bellaire, TX, US

    Job_description.internal_linking.related_jobs
    Case Manager-YBHS

    Case Manager-YBHS

    Gulf Coast CenterAngleton, Texas, United States
    serp_jobs.job_card.full_time
    serp_jobs.filters_job_card.quick_apply
    Are you seeking a career where you can make a difference? Gulf Coast Center (GCC) recruits people who are committed to compassionate, person-centered service. Paid Holidays each year (in addition to...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_30
    • serp_jobs.job_card.promoted
    CASE MANAGER

    CASE MANAGER

    EndeavorsHouston, TX, United States
    serp_jobs.job_card.full_time
    The Case Manager will provide comprehensive case management to clients and their families who are homeless or at risk of homelessness with the goal of increasing their quality of life and maintaini...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_30
    • serp_jobs.job_card.promoted
    Travel Nurse RN - Case Manager - $1,507 per week in Corpus Christi, TX

    Travel Nurse RN - Case Manager - $1,507 per week in Corpus Christi, TX

    TravelNurseSourceHouston, Texas, US
    serp_jobs.job_card.full_time
    TravelNurseSource is working with GetMed Staffing to find a qualified Case Manager RN in Corpus Christi, Texas, 78411!.GetMed Staffing is searching for a strong Case Manager RN to assist our travel...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_30
    • serp_jobs.job_card.promoted
    Case Manager, Life Insurance

    Case Manager, Life Insurance

    Covr Financial TechnologiesHouston, TX, US
    serp_jobs.job_card.full_time
    Reports To : Team Lead, Case Management.Department : Insurance Operations.Work Schedule : M-F, subject to change according to business needs. Location : Houston, Texas (hybrid - 4 days onsite / 1 days rem...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_30
    • serp_jobs.job_card.promoted
    Travel Nurse RN - Case Manager - $1,448 to $1,597 per week in Weatherford, TX

    Travel Nurse RN - Case Manager - $1,448 to $1,597 per week in Weatherford, TX

    TravelNurseSourceHouston, Texas, US
    serp_jobs.job_card.full_time
    TravelNurseSource is working with Host Healthcare to find a qualified Case Manager RN in Weatherford, Texas, 76086!.Host Healthcare is an award-winning travel healthcare company with an immediate o...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_30
    • serp_jobs.job_card.promoted
    Travel Nurse RN - Case Manager - $1,505 to $1,669 per week in Corpus Christi, TX

    Travel Nurse RN - Case Manager - $1,505 to $1,669 per week in Corpus Christi, TX

    TravelNurseSourceHouston, Texas, US
    serp_jobs.job_card.full_time
    TravelNurseSource is working with LRS Healthcare to find a qualified Case Manager RN in Corpus Christi, Texas, 78412!.Ready to start your next travel adventure? LRS Healthcare offers a full benefit...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_30
    • serp_jobs.job_card.promoted
    Supplemental Case Manager

    Supplemental Case Manager

    Memorial Hermann Health SystemHouston, TX, United States
    serp_jobs.job_card.full_time
    At Memorial Hermann, we pursue a common goal of delivering high quality, efficient care while creating exceptional experiences for every member of our community. When we say every member of our comm...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_30
    Case Manager - Galveston County Wellness Center

    Case Manager - Galveston County Wellness Center

    Gulf Coast CenterLa Marque, Texas, United States
    serp_jobs.job_card.full_time
    serp_jobs.filters_job_card.quick_apply
    Are you seeking a career where you can make a difference? Gulf Coast Center (GCC) recruits people who are committed to compassionate, person-centered service. Salary increase upon 90 days of employm...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_30
    • serp_jobs.job_card.promoted
    Travel Nurse RN - ED - Emergency Department

    Travel Nurse RN - ED - Emergency Department

    Junxion Med StaffingCypress, TX, US
    serp_jobs.job_card.permanent
    Junxion Med Staffing is seeking a travel nurse RN ED - Emergency Department for a travel nursing job in Cypress, Texas.Job Description & Requirements. Junxion Med Staffing Job ID #1299652.Pay pa...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_30
    • serp_jobs.job_card.promoted
    Travel Nurse RN - Case Manager - $1,868 per week in Corpus Christi, TX

    Travel Nurse RN - Case Manager - $1,868 per week in Corpus Christi, TX

    TravelNurseSourceHouston, Texas, US
    serp_jobs.job_card.full_time
    TravelNurseSource is working with Care Career to find a qualified Case Manager RN in Corpus Christi, Texas, 78412!.Case managers work to facilitate patient care by assessing patient needs, evaluati...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_30
    • serp_jobs.job_card.promoted
    Travel Nurse RN - Case Manager - $1,780 per week in Corpus Christi, TX

    Travel Nurse RN - Case Manager - $1,780 per week in Corpus Christi, TX

    TravelNurseSourceHouston, Texas, US
    serp_jobs.job_card.full_time
    TravelNurseSource is working with GO Healthcare Staffing to find a qualified Case Manager RN in Corpus Christi, Texas, 78412!. Our client in Corpus Christi TX has a.The ideal candidate must have at ...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_variable_days
    • serp_jobs.job_card.promoted
    Travel Nurse RN - Case Manager - $1,708 to $1,910 per week in Mission, TX

    Travel Nurse RN - Case Manager - $1,708 to $1,910 per week in Mission, TX

    TravelNurseSourceHouston, Texas, US
    serp_jobs.job_card.full_time
    TravelNurseSource is working with Prime Time Healthcare to find a qualified Case Manager RN in Mission, Texas, 78572!.Now Hiring : RN Case Manager - Mission, TX. Contact us for Pay Information.Actual...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_variable_days
    • serp_jobs.job_card.promoted
    Travel Nurse RN - Case Manager - $1,612 per week in Corpus Christi, TX

    Travel Nurse RN - Case Manager - $1,612 per week in Corpus Christi, TX

    TravelNurseSourceHouston, Texas, US
    serp_jobs.job_card.full_time
    TravelNurseSource is working with CrossMed Healthcare to find a qualified Case Manager RN in Corpus Christi, Texas, 78412!. At CrossMed Healthcare Staffing, we aim to create lasting impressions wher...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_30
    • serp_jobs.job_card.promoted
    Travel Nurse RN - Case Manager - $1,824 per week in Corpus Christi, TX

    Travel Nurse RN - Case Manager - $1,824 per week in Corpus Christi, TX

    TravelNurseSourceHouston, Texas, US
    serp_jobs.job_card.full_time
    TravelNurseSource is working with FlexCare to find a qualified Case Manager RN in Corpus Christi, Texas, 78401!.FlexCare is a nationwide leader in the staffing of travel nurses and clinicians.With ...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_30
    • serp_jobs.job_card.promoted
    Travel Nurse RN - Case Manager - $1,576 per week in Corpus Christi, TX

    Travel Nurse RN - Case Manager - $1,576 per week in Corpus Christi, TX

    TravelNurseSourceHouston, Texas, US
    serp_jobs.job_card.full_time +1
    TravelNurseSource is working with Infojini Healthcare to find a qualified Case Manager RN in Corpus Christi, Texas, 78412!. Self Assessment (Skills Checklist).At Infojini Healthcare, We tell it like...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_30
    • serp_jobs.job_card.promoted
    Travel Nurse RN - Case Manager - $1,506 to $1,706 per week in Corpus Christi, TX

    Travel Nurse RN - Case Manager - $1,506 to $1,706 per week in Corpus Christi, TX

    TravelNurseSourceHouston, Texas, US
    serp_jobs.job_card.full_time
    TravelNurseSource is working with Ventura MedStaff to find a qualified Case Manager RN in Corpus Christi, Texas, 78412!.Are you ready to take your Travel career to the next level? See places you h...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_30
    • serp_jobs.job_card.promoted
    Travel Nurse RN - Case Manager - $1,782 per week in Webster, TX

    Travel Nurse RN - Case Manager - $1,782 per week in Webster, TX

    TravelNurseSourceHouston, Texas, US
    serp_jobs.job_card.full_time
    TravelNurseSource is working with Medical Talent to find a qualified Case Manager RN in Webster, Texas, 77598!.Join our dynamic team and embark on a rewarding journey with us! We are Joint Commissi...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_30
    • serp_jobs.job_card.promoted
    Travel Nurse RN - Case Manager - $1,735 to $1,885 per week in Dallas, TX

    Travel Nurse RN - Case Manager - $1,735 to $1,885 per week in Dallas, TX

    TravelNurseSourceHouston, Texas, US
    serp_jobs.job_card.full_time
    TravelNurseSource is working with Host Healthcare to find a qualified Case Manager RN in Dallas, Texas, 75204!.Host Healthcare is an award-winning travel healthcare company with an immediate openin...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_30
    • serp_jobs.job_card.promoted
    Travel Registered Nurse - Case Manager - $1,448 to $1,597 per week in Weatherford, TX

    Travel Registered Nurse - Case Manager - $1,448 to $1,597 per week in Weatherford, TX

    TravelNurseSourceHouston, Texas, US
    serp_jobs.job_card.full_time
    TravelNurseSource is working with Host Healthcare to find a qualified Case Manager RN in Weatherford, Texas, 76086!.Host Healthcare is an award-winning travel healthcare company with an immediate o...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_30
    • serp_jobs.job_card.promoted
    Travel Nurse RN - Case Manager - $1,631 to $1,754 per week in Corpus Christi, TX

    Travel Nurse RN - Case Manager - $1,631 to $1,754 per week in Corpus Christi, TX

    TravelNurseSourceHouston, Texas, US
    serp_jobs.job_card.full_time +1
    TravelNurseSource is working with Advantage Medical Professionals to find a qualified Case Manager RN in Corpus Christi, Texas, 78412!. RN – CASE MANAGEMENT Travel Contract.Join the CASE MANAGEMENT ...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_variable_days