Case Manager Jobs

About The Position

Requirements

• Graduate of an accredited School of Nursing
• RN license in the State of Texas, Current CPR, BLS certification; ACLS preferred
• 5+ years of Registered Nurse experience
• Knowledge of utilization management, discharge planning, and regulatory requirements

Nice To Haves

• Case Management leadership experience preferred
• Compassionate and patient-focused leadership
• Excellent communication, relationship-building, clinical judgement and problem-solving skills
• Commitment to quality, safety, and continuous improvement
• Ability to multitask and perform in a fast-paced environment
• Ability to stand, walk, bend, lift up-to 50 pounds, and assist patients as needed

Responsibilities

• Conduct discharge assessments on admission & develop timely, appropriate discharge plans
• Perform daily patient assessments, monitor, evaluate & document patient progress
• Coordinate post-hospital care & coordinate discharge to home and other care settings
• Provide, document, and coordinate patient and family education; serve as liaison among patients, families, physicians, and the care team
• Document discharge services accurately and timely in accordance with hospital policy
• Maintain individualized patient care plans and update them based on changes in patient status
• Review denials, identify appeal needs, and ensure appropriate appeal completion
• Review continued stay, medical necessity, medical reports and treatment plans
• Facilitate access to financial assistance, advance directives, legal aid, education and medication assistance programs
• Coordinate patient care and rehabilitation using consultation findings and social work expertise
• Partner with Quality Improvement to enhance patient safety, establish goals, and submit monthly quality reports
• Review payer-requested charts and communicate clinical information to payers
• Maintain referral source database & refer patients, families to community resources
• Identify barriers to patient progress & perform social work duties as needed
• Document ongoing physiological, psychosocial assessments, patient and family education and responses & interdisciplinary care plan recommendations
• Validate, transcribe, and co-sign physician orders; report patient progress, and advise physicians and departments on utilization management regulations
• Perform utilization reviews in compliance with state regulations and evolving utilization management regulations
• Monitor daily case management needs & maintain collaborative staff relationships
• Communicate discharge plans with physicians and complete follow-up calls within three days of discharge
• Assist with coordinating quarterly utilization review committee activities and updating policies and procedures
• Perform registered nurse duties in accordance with the RN job description
• Maintain confidentiality and HIPAA compliance when handling sensitive information
• Adhere to organizational behavioral standards personnel policies and customer service expectations
• Perform other duties as assigned

Benefits

• Paid Time Off & Holidays
• Health & Supplemental Insurance
• Direct Deposit
• Fitness Center Membership
• Education Reimbursement
• Retirement Plan