Case Manager Weekend Supplemental
3 weeks ago
Job Summary
The purpose of the Case Manager position is to support the physician, primary medical homes, and interdisciplinary teams in facilitating 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 in 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 provides 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.Job Description
Minimum Qualification
Education: Graduate of an accredited school of professional nursing required; Bachelors of Nursing preferred; or graduate of an accredited Masters of Social Work program (MSW); Master's degree preferred.
Licenses/Certifications:
- 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.
Experience / Knowledge / Skills:
- Three (3) years of experience in hospital-based nursing or social work.
- Experience in utilization management, case management, discharge planning or other cost/quality management program 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.
Principal Accountabilities
- Coordinates/facilitates patient care progression throughout the continuum.
- Works collaboratively and maintains active communication with physicians, nursing and other members of the multi-disciplinary care team to effect timely, appropriate patient care.
- Addresses/resolves system problems impeding diagnostic or treatment progress. Proactively identifies and resolves delays and obstacles to discharge.
- Seeks consultation from appropriate disciplines/departments as required to expedite care and facilitate discharge.
- Utilizes advanced conflict resolution skills as necessary to ensure timely resolution of issues.
- Collaborates with the physician and all members of the multidisciplinary team to facilitate care for designated case load; monitors the patient's progress, intervening as necessary and appropriate to ensure that the plan of care and services provided are patient focused, high quality, efficient, and cost effective; facilitates the following on a timely basis:
- completion and reporting diagnostic testing;
- completion of treatment plan and discharge plan;
- modification of plan of care, as necessary, to meet the ongoing needs of the patient;
- communication to third party payors and other relevant information to the care team;
- assignment of appropriate levels of care;
- completion of all required documentation in TQ screens and patient records.
- Documents key clinical path variances and outcomes which relate to areas of direct responsibility (e.g., discharge planning). Uses pathway data in collaboration with other disciplines to ensure effective patient management concurrently.
- Leads the development, implementation, evaluation and revision of clinical pathways and other Case management tools as a member of the clinical resource/team. Assists in compilation of physician profile data regarding LOS, resource utilization, denied days, costs, case mix index, patient satisfaction and quality indicators (e.g., readmission rates, unplanned return to OR, etc.).
- Acts as preceptor/mentor to new hires. Assists in development of orientation schedule and helps identify individual needs for learning.
- Collaborates with medical staff, nursing staff, and ancillary staff to eliminate barriers to efficient delivery of care in the appropriate setting.
- Completes Utilization Management and Quality Screening for assigned patients.
- Applies approved clinical appropriateness criteria to monitor appropriateness of admissions and continued stays, and documents findings based on Department standards.
- Identifies at-risk populations using approved screening tool and follows established reporting procedures.
- Monitors LOS and ancillary resource use on an ongoing basis. Takes actions to achieve continuous improvement in both areas.
- Refers cases and issues to Care Management Medical Director in compliance with Department procedures and follows up as indicated.
- Communicates with Resource Center to facilitate covered day reimbursement certification for assigned patients. Discusses payor criteria and issues on a case-by-case basis with clinical staff and follows up to resolve problems with payors as needed.
- Uses quality screens to identify potential issues and forwards information to Clinical Quality Review Department.
- Ensures that all elements critical to the plan of care have been communicated to the patient/family and members of the healthcare team and are documented as necessary to assure continuity of care.
- Manages all aspects of discharge planning for assigned patients.
- Meets directly with patient/family to assess needs and develop an individualized continuing care plan in collaboration with physician.
- Collaborates and communicates with multidisciplinary team in all phases of discharge planning process, including initial patient assessment, planning, implementation, interdisciplinary collaboration, teaching and ongoing evaluation.
- Ensures/maintains plan consensus from patient/family, physician and payor.
- Refers appropriate cases for social work intervention based on department criteria.
- Collaborates/communicates with external case managers.
- Initiates and facilitates referrals through the Resource Center for home health care, hospice, medical equipment and supplies.
- Documents relevant discharge planning information in the medical record according to Department standards.
- Facilitates transfer to other facilities as appropriate.
- Actively participates in clinical performance improvement activities.
- Assists in the collection and reporting of financial indicators including case mix, LOS, cost per case, excess days, resource utilization, readmission rates, denials and appeals.
- Uses data to drive decisions and plan/implement performance improvement strategies related to case management for assigned patients, including fiscal, clinical and patient satisfaction data.
- Collects, analyzes and addresses variances from the plan of care/care path with physician and/or other members of the healthcare team. Uses concurrent variance data to drive practice changes and positively impact outcomes.
- Collects delay and other data for specific performance and/or outcome indicators as determined by Director of Outcomes Management.
- Ensures safe care to patients, staff and visitors; adheres to all Memorial Hermann policies, procedures, and standards within budgetary specifications including time management, supply management, productivity and quality of service.
- Promotes individual professional growth and development by meeting requirements for mandatory/continuing education and skills competency; supports department-based goals which contribute to the success of the organization; serves as preceptor, mentor and resource to less experienced staff.
- Demonstrates commitment to caring for every member of our community by creating compassionate and personalized experiences. Models Memorial Hermann's service standards by providing safe, caring, personalized and efficient experiences to patients and colleagues.
- Other duties as assigned.
-
Case Manager
1 week ago
Sugar Land, United States Houston Methodist Sugar Land Hospital Full timeJob Description: At Houston Methodist, the Case Manager PRN (CM) position is a licensed registered nurse (RN) who comprehensively plans for case management of a target patient population on a designated unit(s). This position works with the physicians and interprofessional health care team to facilitate and maintain compassionate, efficient quality care...
-
Supplemental Encephalographic
3 weeks ago
Sugar Land, United States Memorial Hermann Health System Full timeSupplemental Encephalographic (EEG/EMG) Technician at Memorial Hermann Health System summary: The Supplemental Encephalographic Technician at Memorial Hermann is responsible for performing EEG and neurodiagnostic examinations under the supervision of department management. This role includes preparing patients, applying electrodes, and maintaining...
-
Case Manager
2 weeks ago
Sugar Land, United States Houston Methodist Sugar Land Hospital Full timeAt Houston Methodist, the Case Manager PRN (CM) position is a licensed registered nurse (RN) who comprehensively plans for case management of a target patient population on a designated unit(s). This position works with the physicians and interprofessional health care team to facilitate and maintain compassionate, efficient quality care and achievement of...
-
Case Manager
3 weeks ago
Sugar Land, United States Houston Methodist Sugar Land Hospital Full timeAt Houston Methodist, the Case Manager PRN (CM) position is a licensed registered nurse (RN) who comprehensively plans for case management of a target patient population on a designated unit(s). This position works with the physicians and interprofessional health care team to facilitate and maintain compassionate, efficient quality care and achievement of...
-
Occupational Therapist Supplemental Position
3 weeks ago
Sugar Land, Texas, United States Memorial Hermann Health System Full timeAt Memorial Hermann Health System, we are seeking an experienced Occupational Therapist to join our acute care therapy team at our Sugar Land Hospital. This is a supplemental position with minimum shift expectations of 2 weekend shifts (Saturdays and/or Sundays) per month and 1 weekday shift per month. The hours are 10am - 6pm.About the RoleThis occupational...
-
Case Manager II
3 months ago
Sugar Land, United States Encompass Health Full timeCase Manager Career Opportunity Now offering a $10,000 Sign On Bonus for Full Time positions! Recognized for your abilities as a Case ManagerAre you ready for a Case Management role that brings your career closer to home and heart? Join Encompass Health, where being a Case Manager goes beyond just a job; it positions you as a vital link between exceptional...
-
Sugar Land, United States Memorial Hermann Health System Full timeWe are seeking an experienced and compassionate Supplemental Occupational Therapist to join our acute care therapy team at Memorial Hermann Health System in Sugar Land. This is a part-time position with a flexible schedule that includes minimum shift expectations of 2 weekend shifts per month and 1 weekday shift per month.Job SummaryThe Supplemental...
-
Supplemental Nurse Practitioner
3 weeks ago
Sugar Land, United States Memorial Hermann Health System Full timeSupplemental Nurse Practitioner - Critical Care, Nights at Memorial Hermann Health System summary: The Supplemental Nurse Practitioner in Critical Care at Memorial Hermann is responsible for providing high-quality comprehensive patient care through assessment, diagnosis, and treatment. This role emphasizes the importance of safety, compassion, and...
-
Case Manager Certified- Full Time Days
4 days ago
Sugar Land, United States Houston Methodist Sugar Land Hospital Full timeAt 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...
-
Hospice Care Nurse Case Manager
7 days ago
Sugar Land, Texas, United States Preceptor Home Health & Hospice Full timeFull-Time Hospice RN Case Manager PositionWe are currently seeking a Full-Time Hospice RN Case Manager for our Washington and Ozaukee County territories. This role will involve carrying a current RN licensure in the State of Wisconsin and having 2 years of RN level nursing experience preferred.The successful candidate will have excellent communication skills...
-
Nurse Educator and Case Manager
3 weeks ago
Sugar Land, Texas, United States Fresenius Medical Care Full timeFresenius Medical Care, a leading healthcare provider, offers a rewarding opportunity for an experienced Registered Nurse to join our team as a Nurse Educator and Case Manager.Job SummaryWe are seeking a highly skilled and compassionate RN to provide patient education and care coordination services to individuals with end-stage renal disease (ESRD) in their...
-
Case Manager
2 weeks ago
Sugar Land, TX, United States Houston Methodist Sugar Land Hospital Full timeAt Houston Methodist, the Case Manager PRN (CM) position is a licensed registered nurse (RN) who comprehensively plans for case management of a target patient population on a designated unit(s). This position works with the physicians and interprofessional health care team to facilitate and maintain compassionate, efficient quality care and achievement of...
-
Supplemental Occupational Therapist
3 weeks ago
Sugar Land, TX, United States Memorial Hermann Health System Full timeWe are seeking a highly skilled and compassionate Supplemental Occupational Therapist to join our acute care therapy team at Memorial Hermann Health System in Sugar Land, Texas.About the RoleThis is a supplemental position with minimum shift expectations of 2 weekend shifts (Saturdays and/or Sundays) per month and 1 weekday shift per month. As an...
-
Advanced RN Case Manager
3 weeks ago
Sugar Land, Texas, United States AccentCare Full timeAccentCare is a leading provider of home healthcare services, and we are seeking an experienced RN Case Manager to join our team. As a medical professional, you will have the opportunity to make a meaningful difference in the lives of our patients and their families.
-
Support Worker
8 hours ago
Sugar Land, United States Always Best Care Full timeWeekend Caregiver PositionWe are seeking a caring and dependable Weekend Caregiver to provide assistance and support to individuals who require care and assistance during weekends.About the Role:Provide personal care assistance to clients, including bathing, grooming, dressing, and toileting as needed.Assist clients with mobility needs, including...
-
Supplemental Nurse Practitioner
2 weeks ago
Sugar Land, United States Memorial Hermann Health System Full timeAt Memorial Hermann, we pursue a common goal of delivering high quality, efficient care while creating exceptional experiences for every member of our community. When we say every member of our community, that includes our employees. We know that when our employees feel cared for, heard and valued, they are inspired to create moments that exceed...
-
Supplemental Nurse Practitioner
3 weeks ago
Sugar Land, United States Memorial Hermann Health System Full timeAt Memorial Hermann, we pursue a common goal of delivering high quality, efficient care while creating exceptional experiences for every member of our community. When we say every member of our community, that includes our employees. We know that when our employees feel cared for, heard and valued, they are inspired to create moments that exceed...
-
Supplemental Nurse Practitioner
3 weeks ago
Sugar Land, United States Memorial Hermann Health System Full timeAt Memorial Hermann, we pursue a common goal of delivering high quality, efficient care while creating exceptional experiences for every member of our community. When we say every member of our community, that includes our employees. We know that when our employees feel cared for, heard and valued, they are inspired to create moments that exceed...
-
Case Manager
3 weeks ago
Sugar Land, TX, United States Houston Methodist Sugar Land Hospital Full timeAt Houston Methodist, the Case Manager PRN (CM) position is a licensed registered nurse (RN) who comprehensively plans for case management of a target patient population on a designated unit(s). This position works with the physicians and interprofessional health care team to facilitate and maintain compassionate, efficient quality care and achievement of...
-
Supplemental Encephalographic
2 weeks ago
Sugar Land, TX, United States Memorial Hermann Health System Full timeSupplemental Encephalographic (EEG/EMG) Technician at Memorial Hermann Health System summary: The Supplemental Encephalographic Technician at Memorial Hermann is responsible for performing EEG and neurodiagnostic examinations under the supervision of department management. This role includes preparing patients, applying electrodes, and maintaining...
