Case Manager II FT

ScionHealth•Houston, TX

23h

About The Position

The Case Manager II coordinates and facilitates care for the patient population through effective collaboration and communication with Interdisciplinary Care Transitions (ICT) team members. The role follows patients throughout the continuum of care and supports appropriate resource utilization, service delivery, and compliance with external review agencies. It provides ongoing expertise through comprehensive assessment, care planning, plan implementation, and evaluation of individual patient needs. The position integrates case management, utilization review and management, and discharge planning to improve patient management and satisfaction, promote continuity of care, and support cost effectiveness. The role is based at Kindred Hospital Houston Medical Center and Acute Rehabilitation Unit (ARU), which provide specialized care for patients with complex medical needs.

Requirements

Postsecondary nursing education from an accredited school of nursing, such as a certificate, diploma, or program graduation.
At least 2 years of experience in a healthcare setting.
RN state licensure and/or compact state licensure in the state of practice upon hire, or LCSW/LSW licensure upon hire.
Knowledge of government and non-government payor practices, regulations, standards, and reimbursement.
Knowledge of Medicare benefits, insurance processes and contracts, accreditation standards, and compliance requirements.
Critical thinking, prioritization, and time-management skills.
Basic computer skills and working knowledge of Microsoft Office, word-processing, and spreadsheet software.
Strong interpersonal, verbal, and written communication skills to obtain cooperation and collaboration from hospital leadership, physicians, payors, and external customers.
Good interpersonal skills when interacting with patients, families, and staff.
Fluent English reading, writing, and speaking skills.
Good and regular attendance.

Nice To Haves

Bachelor’s degree in nursing or social work, such as BSN, MSN, BSW, or MSW.
Prior experience in case management, utilization review, or discharge planning.
CSWCM Social Work Case Manager Certification upon hire.

Responsibilities

Coordinate clinical and psychosocial activities with the Interdisciplinary Team and physicians.
Monitor patients’ stays to support effective care coordination and efficient care facilitation.
Refer high-risk patients who may benefit from additional support.
Serve as a patient advocate and support patients and families in making informed decisions.
Apply knowledge of growth and development across the life span to provide age-appropriate care.
Participate in interdisciplinary patient care rounds and conferences to review treatment goals, optimize resource utilization, provide family education, and identify post-hospital needs.
Collaborate with clinical staff to develop and execute plans of care and achieve goals.
Coordinate care planning across the continuum with the interdisciplinary care team, physicians, patients, families, post-acute providers, payors, and others.
Maintain current knowledge of reimbursement modalities, community resources, and case management, psychosocial, and legal issues affecting patients and care providers.
Perform other related duties as assigned.