About this opportunity
Houston Methodist lists this Case Manager opportunity in shenandoah, Texas. Review the employer’s description below for duties, qualifications and application requirements.
Job description
Full Time, Days
nAt Houston Methodist, the Case Manager (CM) position is a registered nurse (RN) responsible for comprehensively assessing clinical condition and planning for case management, which includes care transitions and discharge planning of a targeted patient population on a designated unit(s) and/or service lines. This position works with the physicians and multidisciplinary healthcare team to facilitate clinical care coordination and maintain compassionate, efficient, quality and safe patient care and achievement of desired treatment outcomes. The CM position holds joint accountability with the social worker for discharge planning, coordination of care, and throughput, assuring that admission and continued stay are medically necessary. This position communicates clinical information to payors and post-acute care providers to ensure safe transition and continuity of care.
nFLSA STATUS
nExempt
nQUALIFICATIONS
nEDUCATION
nnnGraduate of education program approved by the credentialing body for the required credential(s) indicated below in the Certifications, Licenses and Registrations section.
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nnBachelor’s degree preferred
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n nEXPERIENCE
nnnThree years hospital nursing clinical experience
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nnAcute care case management experience preferred
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n nLICENSES AND CERTIFICATIONS
nRequired
nnRN - Registered Nurse - Texas State Licensure - Texas Board of Nursing_PSV Compact Licensure – Must obtain permanent Texas license within 60 days (if establishing Texas residency)
n nKNOWLEDGE AND ABILITIES
nnnDemonstrates the skills and competencies necessary to safely perform the assigned job, determined through ongoing skills, competency assessments, and performance evaluations
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nnSufficient proficiency in speaking, reading, and writing the English language necessary to perform the essential functions of this job, especially with regard to activities impacting patient or employee safety or security
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nnAbility to effectively communicate with patients, physicians, family members and co-workers in a manner consistent with a customer service focus and application of positive language principles
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nnKnowledge of Medicare, Medicaid and Managed Care requirements
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nnProgressive knowledge of community resources, healthcare financial and payor requirements/issues, and eligibility for state, local and federal programs
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nnProgressive knowledge of discharge planning, utilization management, case management, performance improvement and managed care reimbursement
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nnUnderstanding of pre-acute and post-acute venues of care and post-acute community resources
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nnAbility to work independently and exercise sound judgment in interactions with physicians, payors, and patients and their families
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nnWell versed in computer skills of the entire Microsoft Office Suite (Excel, Outlook, PowerPoint and Word)
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nnStrong assessment, organizational and problem-solving skills
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n nESSENTIAL FUNCTIONS
nPEOPLE ESSENTIAL FUNCTIONS
nnnCommunicates in an active, positive and effective manner to all healthcare team members and reports pertinent clinical patient care and family data in a comprehensive and unbiased manner; listens and responds to the ideas of others. Supports patients and families in preventing/resolving clinical or ethical issues.
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nnCollaborates with staff from the multidisciplinary care team concerning the discharge plan to improve outcomes and the safe transition of care. Uses a structured format for regular communication with patients and families.
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nnCommunicates effectively with physicians, multidisciplinary care team, patients, and families to ensure safe and timely transitions of care.
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nnContributes towards improvement of employee engagement as reflected by department scores, i.e., peer-to-peer accountability.
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n nSERVICE ESSENTIAL FUNCTIONS
nnnAssesses all patients timely, per policy, and thoroughly. Reviews chart for medical necessity and facilitation of throughput and appropriate utilization of inpatient resources and services, etc. Initiates and facilitates referrals and transfers for home health care, hospice, durable medical equipment, and other post-acute services.
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nnParticipates and is prepared to present barriers to efficient patient throughput in daily multi-disciplinary rounds (MDRs). Escalates appropriate discharge barriers to leadership and/or physician advisor.
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nnFacilitates discharge planning activities for assigned patients and collaborates with other members of the multidisciplinary care team, as well as patient and family, on clinically complex care transitions and discharges. Maintains ownership of the discharge planning process on assigned units.
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n nQUALITY/SAFETY ESSENTIAL FUNCTIONS
nnnModifies care based on continuous evaluation of the patient’s medical condition and progression. Demonstrates clinical problem-solving and critical thinking within the scope of practice and makes decisions using an evidence-based analytical approach. Documents accurate assessment and interventions efficiently and effectively.
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nnEducates patient and family appropriately on disease process that impacts their health and readmission. Connects patient and family with resources related to their disease process.
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nnProactively plans for routine discharge, elevates emergent situations, and escalates unresolved barriers. Manages usual patient assignment and other unit demands, anticipating/planning for potential problems.
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nnFocuses on discharge domain by contributing to department and hospital targets for quality, patient satisfaction and safety measures.
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n nFINANCE ESSENTIAL FUNCTIONS
nnnFocuses on reducing length of stay for all levels of care, (inpatient, observation and outpatient in a bed) and avoidable days by ensuring efficient and timely use of resources in discharge planning and transitions. Reviews medical records for medical necessity for continued stay, facilitate timely discharge to reduce discharge delays.
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nnApplies knowledge of payor requirements and coverage to facilitate cost-effective discharges. Contributes to meeting department and hospital financial targets. Utilizes resources with cost effectiveness and value creation in mind. Self-motivated to independently manage time effectively and prioritize daily tasks, assisting coworkers as needed.
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n nGROWTH/INNOVATION ESSENTIAL FUNCTIONS
nnnIdentifies areas for process improvement based on understanding of evidence-based practice literature. Participates in evidence-based practice/performance improvement projects based on these observations and offers solutions.
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nnSeeks opportunities to identify self-development needs and takes appropriate action. Ensures own career discussions occur with appropriate management. Completes and updates the My Development Plan on an ongoing basis.
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n nSUPPLEMENTAL REQUIREMENTS
nWORK ATTIRE
nnnUniform: No
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nnScrubs: No
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nnBusiness professional: Yes
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nnOther (department approved): No
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n nON-CALL *
n*Note that employees may be required to be on-call during emergencies (ie. Disaster, Severe Weather Events, etc) regardless of selection below.
nnOn Call* Yes
n nTRAVEL **
nTravel specifications may vary by department
nnnMay require travel within the Houston Metropolitan area Yes
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nnMay require travel outside Houston Metropolitan area No
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n nQUALIFICATIONS
nEDUCATION
nnnGraduate of education program approved by the credentialing body for the required credential(s) indicated below in the Certifications, Licenses and Registrations section.
n
nnBachelor’s degree preferred
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n nEXPERIENCE
nnnThree years hospital nursing clinical experience
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nnAcute care case management experience preferred
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n nLICENSES AND CERTIFICATIONS
nRequired
nnRN - Registered Nurse - Texas State Licensure - Texas Board of Nursing_PSV Compact Licensure – Must obtain permanent Texas license within 60 days (if establishing Texas residency)
n nCompany Profile:
nHouston Methodist The Woodlands Hospital opened in June 2017. This 725,000-square-foot, full-service, acute-care hospital offers many of the same services as our flagship hospital in the Texas Medical Center. Also, on the beautiful hospital campus, located at the intersection of Interstate 45 and Texas State Highway 242, are two medical office buildings, which include a Breast Care Center; Cancer Center; infusion center; heart and vascular services; neurology; orthopedics and sports medicine; rehabilitation services; wellness services; an outpatient laboratory; and several other multispecialty physician practices. In January 2022, Houston Methodist The Woodlands opened Healing Tower — a $250 million expansion project that added 106 beds, focused on medical-surgical and women’s services, and provided nine operating rooms. The project also included the expansion of the endoscopy center, emergency department and diagnostic imaging department with an enhanced neurodiagnostic and interventional center.
nHouston Methodist is an Equal Opportunity Employer.
Who can apply
Review the original listing for work authorization, qualifications and employer requirements.