Current jobs related to Certified Case Manager - Del Rio - Houston odist Cypress Hospital

  • Certified Case Manager

    4 weeks ago

    Rio, United States Houston odist Cypress Hospital Full time

    At Houston Methodist the Case Manager (CM) Certified position is a registered nurse (RN) responsible for comprehensively planning for case management of a targeted patient population on a designated unit(s) and/or service line. This position works with the physicians and interprofessional healthcare team to facilitate and maintain compassionate efficient...

  • Per Diem Weekend Registered Nurse

    4 weeks ago

    Del Rio, Texas, United States Professional Case Management Full time

    Make a Difference on Your Own ScheduleAt Professional Case Management, we offer a unique opportunity for Registered Nurses to work on a per diem/PRN basis as a Certified Mobile Research Nurse. This role allows you to work cooperatively with our Clinical Project Managers, Coordinators, and site personnel to complete visits and submit accurate source...

  • Certified Dietary Manager

    1 month ago

    Del Rio, Texas, United States Regency Integrated Health Services Full time

    Job SummaryWe are seeking a highly skilled and experienced Certified Dietary Manager to lead our dietary department at Val Verde Nursing and Rehabilitation Center in Del Rio, TX. As a key member of our team, you will be responsible for ensuring the highest quality food service and maintaining a safe and healthy environment for our residents.Key...

  • Travel Nurse RN Case Manager

    6 days ago

    Rio Rancho, New Mexico, United States MedPro Healthcare Staffing Full time

    MedPro Healthcare Staffing is seeking a travel nurse RN Case Management professional for a travel nursing job in a top healthcare facility.Job Description & RequirementsSpecialty: Case ManagementDiscipline: RNEmployment Type: TravelMedPro Healthcare Staffing, a Joint Commission-certified staffing agency, is seeking a quality Case Manager Registered Nurse...

  • RN Case Manager, Emergency Department

    2 weeks ago

    Marina del Rey, California, United States Cedars Sinai Full time

    Make a Difference Every DayAt Cedars-Sinai Marina Del Rey Hospital, we're committed to delivering exceptional patient care and making a positive impact on our community. As an RN Case Manager in our Emergency Department, you'll play a vital role in coordinating and implementing case management strategies to ensure our patients receive the highest quality...

  • Field Nurse Case Manager

    2 weeks ago

    Aragüés del Puerto, Huesca, United States Apogee Solutions Full time

    Job Title: Field Nurse Case ManagerApogee Solutions is seeking a Field Nurse Case Manager to support the United States Department of Labor (DOL) Nurse and Vocational Rehabilitation Services (NVRS) contract in the Northern Virginia area.The ideal candidate will have a strong background in adult medical/surgical nursing and case management experience in the...

  • Nurse Case Manager

    2 weeks ago

    Rio Rancho, New Mexico, United States ATC Marietta Full time

    About ATC HealthcareATC Healthcare is a leading provider of healthcare professionals to hospitals and facilities nationwide. With over 40 years of experience, we have established ourselves as a trusted partner in the healthcare industry.Job SummaryWe are seeking a skilled Registered Nurse RN to join our team as a Case Manager. As a Case Manager, you will be...

  • Nurse Case Manager

    1 month ago

    Rio Rancho, New Mexico, United States ATC Marietta Full time

    Job Title: Registered Nurse - Case ManagerWe are seeking a skilled Registered Nurse to join our team as a Case Manager. As a Case Manager, you will be responsible for coordinating patient care and ensuring that patients receive the best possible treatment.About ATC Healthcare ServicesATC Healthcare Services is a leading provider of healthcare professionals...

  • Clinical Social Worker

    4 weeks ago

    Aragüés del Puerto, Huesca, United States Kaiser Full time

    Job SummaryThis position is eligible for a $20,000 sign-on bonus. As a Clinical Social Worker - Case Manager, you will be responsible for collaborating with the healthcare team to facilitate the coordination of appropriate, cost-effective services that are consistent with the member's plan of care, helping them achieve their optimal level of independence,...

  • Nurse Case Manager

    5 days ago

    Rio Rancho, New Mexico, United States ALOIS Healthcare Full time

    At ALOIS Healthcare, we're seeking a dedicated Nurse Case Manager to join our team in Rio Rancho, New Mexico. This 13-week travel nursing assignment presents a unique opportunity to make a meaningful impact in the lives of our patients and their families.Job SummaryAs a Nurse Case Manager, you will serve as a patient advocate, ensuring that our patients...

  • Case Manager RN

    2 weeks ago

    Rio Rancho, New Mexico, United States University of New Mexico - Hospitals Full time

    Job Title: Case Manager RNJob Summary:We are seeking a skilled and compassionate Case Manager RN to join our team at the University of New Mexico - Hospitals. As a Case Manager RN, you will play a vital role in coordinating patient care, ensuring quality and cost-effective outcomes, and promoting patient-centered care.Key Responsibilities:Coordinate patient...

  • Nurse Case Manager

    2 weeks ago

    Rio Rancho, New Mexico, United States ATC Marietta Full time

    About ATC HealthcareATC Healthcare is a leading provider of healthcare professionals to hospitals and facilities nationwide. With over 40 years of experience, we have established ourselves as a trusted partner for healthcare systems across the U.S.Job DescriptionWe are seeking a skilled Registered Nurse RN to join our team as a Case Manager. As a Case...

  • Nurse Case Manager

    1 month ago

    Rio Rancho, New Mexico, United States ATC Marietta Full time

    About ATC HealthcareATC Healthcare has been a leading provider of nurses and healthcare professionals to hospitals and facilities nationwide for over 40 years.We partner with healthcare systems, including municipal health systems, multi-unit senior care companies, governments, and school systems, to deliver high-quality healthcare professionals on-demand.Job...

  • Nurse Case Manager

    4 weeks ago

    Rio Rancho, New Mexico, United States University of New Mexico Full time

    Job Title: Registered Nurse Case ManagerWe are seeking a highly skilled Registered Nurse Case Manager to join our team at the University of New Mexico. As a key member of our healthcare team, you will be responsible for coordinating patient care and ensuring quality, cost-effective outcomes.Key Responsibilities:Coordinate patient care and develop...

  • RN Case Manager, Inpatient and Emergency Department

    4 weeks ago

    Marina del Rey, California, United States Cedars-Sinai Full time

    Make a Difference Every DayCedars-Sinai Marina Del Rey Hospital is a place where every effort, every detail, and every second matters. Our team of world-class healthcare professionals is dedicated to providing the highest quality care to our patients.Position Summary:As an RN Case Manager, you will be responsible for coordinating and implementing case...

  • Case Manager RN

    3 weeks ago

    Rio Rancho, New Mexico, United States University of New Mexico - Hospitals Full time

    Job Title: Case Manager Registered NurseJoin the University of New Mexico - Hospitals team as a Case Manager Registered Nurse and play a vital role in coordinating patient care and ensuring quality, cost-effective outcomes.Job Summary:As a Case Manager Registered Nurse, you will be responsible for coordinating all systems and services required for an...

  • Nurse Case Manager

    2 weeks ago

    Rio Rancho, New Mexico, United States University of New Mexico - Hospitals Full time

    Job SummaryWe are seeking a skilled Registered Nurse Case Manager to join our team at the University of New Mexico - Hospitals. As a key member of our Case Management department, you will play a vital role in coordinating patient care and ensuring the highest quality outcomes.Key ResponsibilitiesCoordinate patient care plans, working closely with physicians,...

  • Nurse Case Manager

    2 weeks ago

    Aragüés del Puerto, Huesca, United States Inova Health System Full time

    Inova Health System is seeking a skilled Nurse Case Manager to provide exceptional care to patients in acute and post-acute settings. As a key member of the healthcare team, you will be responsible for coordinating services, acting as a liaison between patients, families, and interdisciplinary healthcare members, and utilizing management techniques to...

  • Nurse Case Manager

    2 weeks ago

    Rio Rancho, New Mexico, United States University of New Mexico - Hospitals Full time

    Job SummaryWe are seeking a skilled Registered Nurse Case Manager to join our team at the University of New Mexico - Hospitals. As a key member of our Case Management department, you will play a vital role in coordinating patient care and ensuring the highest quality outcomes.Key ResponsibilitiesCoordinate patient care plans with interdisciplinary teams to...

  • Nurse Case Manager

    2 weeks ago

    Rio Rancho, New Mexico, United States University of New Mexico Full time

    Job SummaryWe are seeking a skilled Registered Nurse Case Manager to join our team at the University of New Mexico. As a key member of our healthcare team, you will be responsible for coordinating patient care and ensuring quality, cost-effective outcomes.Key ResponsibilitiesCoordinate patient care and develop comprehensive treatment plans in collaboration...

Certified Case Manager

2 months ago

Del Rio, United States Houston odist Cypress Hospital Full time

At Houston Methodist the Case Manager (CM) Certified position is a registered nurse (RN) responsible for comprehensively planning for case management of a targeted patient population on a designated unit(s) and/or service line. This position works with the physicians and interprofessional healthcare team to facilitate and maintain compassionate efficient quality care and achievement of desired treatment outcomes. The CM Certified position holds joint accountability with social workers for discharge planning and continuity of care and assures that admission and continued stay are medically necessary communicating clinical information to payors to ensure reimbursement. In addition to performing the duties of a CM this position helps drive change by identifying areas where performance improvement is needed e.g. daytoday workflow education process improvements patient satisfaction.

PEOPLE ESSENTIAL FUNCTIONS
  • Collaborates with the physician and all members of the interprofessional healthcare team to facilitate care for designated assignment; monitors the patients progress intervening as needed to ensure that the plan of care and services provided are patientfocused high quality efficient and costeffective.
  • Serves as a preceptor and implements staff education specific to patient populations and unit processes; coaches and mentors other staff and students. Serves a resource for department and hospital. Provides education to physicians nurses and other healthcare providers on case management topics.
  • Conducts self in a manner that is congruent with cultural diversity equity and inclusion principles. Initiates contributions towards improvement of department scores for employee engagement i.e. peertopeer accountability.

SERVICE ESSENTIAL FUNCTIONS
  • Performs review for medical necessity of admission continued stay and resource use appropriate level of care and program compliance. Identifies when services no longer meet InterQual/Milliman l criteria initiates discussion with attending physicians coordinates with the external case manager to facilitate discharge planning seeks assistance from the physician advisor if needed and informs management of the possible need for issuing Medicare Hospital Initiated Notice of Noncoverage.
  • Applies approved utilization criteria to monitor appropriateness of admissions level of care resource utilization and continued stay. Reviews level of care denials to identify trends and collaborate with team to recommend opportunities for process improvement.
  • Plans for routine/difficult discharge and anticipates/prevents and manages emergent situations. Facilitates timely:
    Assessment and intervention to prevent or reduce readmission
    completion of treatment plan and discharge plan
    modification of plan of care as necessary to meet the ongoing needs of the patient
    assignment of appropriate levels of care
    completion of all required documentation in designated EMR and applications or programs
    elimination of discharge barriers

QUALITY/SAFETY ESSENTIAL FUNCTIONS
  • Documents assessment and interventions efficiently and effectively. Proactively takes action to achieve continuous improvement and expedite care/facilitate discharge.
  • Performs postdischarge review by analyzing the inpatient record to ensure that compliance with quality indicators are met. Intervenes and takes appropriate action to foster realtime compliance with CMS guidelines and other performance measures associated with certification programs and other regulatory national regional or locally sponsored quality programs. Provides reports as needed to appropriate parties showing:
    compliance with established governmental and/or institutional rules and regulations
    analysis of problematic areas and
    actions taken to improve compliance
  • Conducts chart audits and performs peertopeer evaluations for continuous quality improvement.
  • Identifies opportunities to improve patient satisfaction with focus on discharge domain and collaborates with unit leadership to implement evidencebased patient engagement strategies.

FINANCE ESSENTIAL FUNCTIONS
  • Monitors Length of Stay (LOS) for assigned cases on an ongoing basis. Identifies population and/or servicespecific trends impacting LOS and addresses/resolves problems impeding treatment progress. Contributes to meeting department and hospital financial targets with focus on length of stay.
  • Manages all patients in Observation Status informing physicians of timely disposition options to assure maximum benefits for patients and reimbursement for the hospital.
  • Secures reimbursement for hospital services by communicating medical information required by all external review entities managed care contracts insurers fiscal intermediaries state and federal agencies. Responds to requests for information monitors covered days initiates review to assure that all days are covered and reimbursable.

GROWTH/INNOVATION ESSENTIAL FUNCTIONS
  • Identifies opportunity for practice changes. Offers innovative solutions through evidencebased practice/performance improvement projects and shared governance activities.
  • Seeks opportunities to identify selfdevelopment needs and takes appropriate action. Ensures own career discussions occur with appropriate management. Completes and updates the My Development Plan on an ongoing basis.

This job description is not intended to be allinclusive; the employee will also perform other reasonably related business/job duties as assigned. Houston Methodist reserves the right to revise job duties and responsibilities as the need arises.EDUCATION
  • Bachelors degree or higher in nursing
  • Masters degree preferred

WORK EXPERIENCE
  • Five years hospital clinical nursing experience which includes two years in case management
LICENSES AND CERTIFICATIONS REQUIRED
  • RN Registered Nurse Texas State Licensure and/or Compact State Licensure within 60 days OR
  • RNTemp Registered Nurse Temporary State Licensure within 60 days AND
  • Magnet ANCC Recognized Certification Case Managementrelated OR
  • ACM Accredited Case Manager (NBCM) National Board for Case Management
KNOWLEDGE SKILLS AND ABILITIES
  • Demonstrates the skills and competencies necessary to safely perform the assigned job determined through ongoing skills competency assessments and performance evaluations
  • Sufficient 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
  • Ability to effectively communicate with patients physicians family members and coworkers in a manner consistent with a customer service focus and application of positive language principles
  • Comprehensive knowledge of Medicare Medicaid and Managed Care requirements
  • Comprehensive knowledge of community resources health care financial and payor requirements/issues and eligibility for state local and federal programs
  • Comprehensive knowledge of discharge planning utilization management case management performance improvement and managed care reimbursement.
  • Understanding of preacute and postacute venues of care and postacute community resources
  • Ability to work independently
  • Strong assessment organizational and problemsolving skill as evidenced by capacity to prioritize multiple tasks and role components
  • Demonstrates critical thinking and makes decisions using evidencebased analytical approach in interactions with physicians payors and patients and their families
  • Competent computer skills of the entire Microsoft Office Suite (Access Excel Outlook PowerPoint and Word)

SUPPLEMENTAL REQUIREMENTS

WORK ATTIRE

  • Uniform No
  • Scrubs No
  • Business professional Yes
  • Other (department approved) No

ONCALL*
*Note that employees may be required to be oncall during emergencies (ie. DIsaster Severe Weather Events etc) regardless of selection below.

  • On Call* Yes

TRAVEL**
**Travel specifications may vary by department**

  • May require travel within the Houston Metropolitan area Yes
  • May require travel outside Houston Metropolitan area No

Company Profile:

Houston Methodist Cypress Hospital scheduled to open in the first quarter of 2025 will be Houston Methodists ninth hospital and will incorporate the most advanced technology available from the day the doors open. With 100 beds (at our opening; licensed for 276) and a prime location in the heart of the rapidly growing U.S. 290 corridor the hospital will be equipped with technologically advanced innovations implemented during COVID many of them designed to make patient communication with physicians staff and families the very best and most effective in any health care facility. Even though the hospital wont be fully operational until 2025 we have several services and specialties opening in 2024.

Houston Methodist is an equal opportunity employer inclusive of women minorities disabled persons and veterans.

Equal Employment Opportunity

Houston Methodist is an Equal Opportunity Employer.

Equal employment opportunity is a sound and just concept to which Houston Methodist is firmly bound. Houston Methodist will not engage in discrimination against or harassment of any person employed or seeking employment with Houston Methodist on the basis of race color religion sex sexual orientation gender identity national origin age disability status as a protected veteran or other characteristics protected by law. VEVRAA Federal Contractor priority referral Protected Veterans requested.