Case Manager
White Rock Medical CenterDallas, TX, USjob_description.job_card.30_days_ago
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job_description.job_card.job_descriptionCurrent, active RN license in the state of Texas (or compact license with Texas eligibility). Minimum 3 years of clinical experience in a hospital setting, with strong preference for experience in inpatient acute care. At least 1 year of experience in case management, discharge planning, or utilization review preferred. Familiarity with insurance coverage policies including Medicare, Medicaid, and commercial payors. Working knowledge of electronic medical records and hospital workflows. Strong communication, organizational, and critical thinking skills. Ability to manage competing priorities and coordinate across multiple stakeholders in a dynamic environment. Case Management certification (CCM, ACM, or equivalent) Bachelor’s degree in Nursing (BSN) Bilingual (English / Spanish) Full-time, onsite position Monday–Friday, with occasional weekend or holiday rotation based on patient care needs
Job Description
Job Description
Description :
Key Responsibilities :
- Lead daily care coordination for a caseload of inpatient acute care patients, ensuring appropriate level of care and timely discharge planning.
- Conduct utilization reviews to evaluate medical necessity and support appropriate resource use in compliance with regulatory standards.
- Develop and execute individualized discharge plans, including referrals to post-acute services such as home health, SNFs, rehab, and community-based supports.
- Act as a liaison among patients, families, medical providers, and insurance representatives to resolve barriers to care and discharge.
- Identify high-risk patients early in their stay and proactively intervene to minimize delays and avoidable readmissions.
- Facilitate interdisciplinary rounds and collaborate with physicians, nurses, and social workers to align care plans and escalate concerns when needed.
- Ensure accurate and timely documentation that meets CMS, Joint Commission, and hospital standards.
- Participate in department initiatives to improve care transitions, reduce length of stay, and enhance patient outcomes.
Qualifications :
Preferred Qualifications :
Work Requirements :
Requirements : Work Requirements :
Full-time, onsite position
Monday–Friday, with occasional weekend or holiday rotation based on patient care needs
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Case Manager • Dallas, TX, US