Case Manager

1 month ago

Houston, United States Bryce Poynt Consulting Full time
Job DescriptionJob Description

Must-Haves

  • Education: Graduate of an accredited school of professional nursing required; Bachelor of Nursing preferred, or graduate of an accredited Master of Social Work program.
  • Current and valid license to practice as a Registered Nurse in the state of Texas or Current and valid license as a Master Social Worker (LMSW) in the state of Texas required, LCSW preferred.
  • Certification in Case Management required within two (2) years of hire into the Case Manager position.
  • Must have recent acute care case manager hospital experience. Three (3) years of nursing or social work experience acute hospital-based preferred, or three (3) years of experience comparable clinical setting.

Job Description:

The purpose of the Case Manager position is to support the physician, primary medical homes, and interdisciplinary teams. Facilitates patient care, with the underlying objective of enhancing the quality of clinical outcomes and patient satisfaction while managing the cost of care and providing timely and accurate information to payors. The role integrates and coordinates resource utilization management, care facilitation, and discharge planning functions. In addition, the Case Manager helps drive change by identifying areas where performance improvement is needed (e.g., day-to-day workflow, education, process improvements, patient satisfaction). The position is responsible for coordinating a wide range of self-management support and providing information to update and maintain relevant disease registry activity. Accountable for a designated patient caseload and plans effectively in order to meet patient needs across the continuum, provide family support, manage the length of stay, and promote efficient utilization of resources.

Experience / Knowledge / Skills:

  • Three (3) years of nursing or social work experience in acute hospital-based preferred, or three (3) years of experience comparable clinical setting (i.e., ambulatory surgery center, infusion/dialysis clinic, Federally Qualified Health Clinic (FQHC), skilled nursing facility, or wound clinic).
  • Experience in utilization management, case management, discharge planning or other cost/quality management programs preferred.
  • Excellent interpersonal communication and negotiation skills.
  • Demonstrated leadership skills.
  • Strong analytical, data management, and PC skills.
  • Current working knowledge of discharge planning, utilization management, case management, performance improvement, disease or population management, and managed care reimbursement.
  • Understanding of pre-acute and post-acute venues of care and post-acute community resources, physician office routines, and transitional procedures for pre and post-acute care. Demonstrated understanding of motivational interviewing and change management.
  • Strong organizational and time management skills, as evidenced by capacity to prioritize multiple tasks and role components.
  • Ability to work independently and exercise sound judgment in interactions with physicians, payors, and patients and their families.
  • Effective oral and written communication skills.

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