Supplemental Case Manager

3 weeks ago

Katy, Texas, United States Memorial Hermann Health System Full time

At Memorial Hermann Health System, we are committed to delivering high-quality, patient-centered care. As a Supplemental Case Manager, you will play a vital role in facilitating patient care progression throughout the continuum.

Job Summary

The purpose of this position is to support physicians, primary medical homes, and interdisciplinary teams in coordinating patient care, with the goal of enhancing clinical outcomes and patient satisfaction while managing costs and providing timely information to payors. The role integrates and coordinates resource utilization management, care facilitation, and discharge planning functions. Additionally, the Supplemental Case Manager will help drive change by identifying areas where performance improvement is needed, such as day-to-day workflow, education, and process improvements. 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, the Supplemental Case Manager will plan effectively to meet patient needs across the continuum, provide family support, manage length of stay, and promote efficient utilization of resources. Key Responsibilities
  • Coordinates/facilitates patient care progression throughout the continuum.
  • Works collaboratively and maintains active communication with physicians, nursing, and other members of the multidisciplinary 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 caseload; 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 of 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.

  • Medical Case Manager

    3 weeks ago

    Katy, Texas, United States Memorial Hermann Health System Full time

    Job SummaryWe are seeking a highly skilled Medical Case Manager to join our team at Memorial Hermann Health System. As a key member of our care management team, you will play a critical role in facilitating patient care, enhancing clinical outcomes, and promoting efficient resource utilization.Key ResponsibilitiesSupport physicians, primary medical homes,...

  • Bilingual Case Manager

    3 weeks ago

    Katy, Texas, United States Upbring Full time

    About UpbringWe are a non-profit organization dedicated to breaking the cycle of child abuse. Our mission is to provide a safe and supportive environment for children and families in need.Job SummaryWe are seeking a highly motivated and experienced Bilingual Case Manager to join our team. The successful candidate will be responsible for providing quality...

  • Bilingual Case Manager

    4 weeks ago

    Katy, Texas, United States Upbring Full time

    About UpbringWe are a non-profit organization dedicated to breaking the cycle of child abuse. Our mission is to provide a safe and supportive environment for children and families in need.Job SummaryWe are seeking a highly motivated and experienced Bilingual Case Manager to join our team. The successful candidate will be responsible for providing case...

  • Hospice Nurse Case Manager

    1 month ago

    Katy, Texas, United States A Hug Away Full time

    About the RoleA Hug Away Healthcare, Inc. is seeking a dedicated and compassionate Licensed Vocational Nurse (LVN) to join our team as a Case Manager in hospice care. This office-based position involves coordinating patient care, ensuring quality assurance standards, and providing administrative support.Key ResponsibilitiesQuality Assurance: Ensure...

  • Property Manager

    4 weeks ago

    Katy, Texas, United States National Storage Affiliates Full time

    Job SummaryWe are seeking a highly motivated and customer-focused Property Manager to join our team at National Storage Affiliates. As a Property Manager, you will play a crucial role in managing day-to-day operations, ensuring exceptional customer service, and contributing to the overall success of the organization.Key ResponsibilitiesManage daily property...

  • Assistant Property Manager

    4 weeks ago

    Katy, Texas, United States National Storage Affiliates Full time

    Job SummaryWe are seeking a highly motivated and customer-focused individual to join our team as an Assistant Property Manager. As a key member of our operations team, you will play a crucial role in managing day-to-day property operations, ensuring exceptional customer service, and contributing to the overall success of our organization.Key...

  • Quality Assurance Manager

    3 weeks ago

    Katy, Texas, United States Grundfos Full time

    Quality Manager Job DescriptionGrundfos is seeking an experienced Quality Manager to represent the IND Region of the Americas with a focus on quality.The Quality Manager will ensure the effective management of operational, tactical, and strategic tasks and initiatives pertaining to IND Quality.Key Responsibilities:Lead and exemplify cross-functional teamwork...

  • Bilingual Care Coordinator

    4 weeks ago

    Katy, Texas, United States Upbring Full time

    About Our Children's SheltersAt Upbring, we are committed to breaking the cycle of child abuse. Our children's shelters provide a safe and supportive environment for children who have experienced trauma. We offer a range of services, including case management, counseling, and education, to help children heal and thrive.Job SummaryWe are seeking a skilled and...

  • Client Relations Coordinator

    1 month ago

    Katy, Texas, United States The Debt Defenders by Ciment Law Firm, PLLC Full time

    Client Relations and Case Management OpportunityThe Debt Defenders by Ciment Law Firm, PLLC is seeking a highly skilled and compassionate Intake Specialist to join our team. As a key member of our client relations team, you will play a vital role in managing our growing caseload and taking our client relations to the next level.Key Responsibilities:Evaluate...

  • Operating Room Nurse PRN Position

    3 weeks ago

    Katy, Texas, United States United Surgical Partners Full time

    Job SummaryThe Operating Room Nurse provides nursing care and service during surgery cases. This role is responsible for positioning the patient, prepping the patient, and circulating the case. The ideal candidate will have experience in surgical procedures in various specialties, including Orthopedics, ENT, General, GI, Gynecology, Ophthalmology, Pain,...

  • Docket Legal Assistant

    4 weeks ago

    Katy, Texas, United States The Debt Defenders by Ciment Law Firm, PLLC Full time

    Job DescriptionWe are seeking a detail-oriented Docket Legal Assistant to join our Debt Resolution Team. In this role, you will play a crucial part in ensuring that all scheduled hearings across Texas are seamlessly coordinated with dedicated appearance attorneys and meticulously prepared hearing instructions catered to each case's...

  • Clinical Care Coordinator

    3 weeks ago

    Katy, Texas, United States Memorial Hermann Health System Full time

    Job Summary: We are seeking a skilled Clinical Care Coordinator to join our team at Memorial Hermann Health System. As a key member of our interdisciplinary care team, you will play a vital role in facilitating patient care progression throughout the continuum.Key Responsibilities: Coordinates/facilitates patient care progression throughout the...

  • Healthcare Private Duty Nurse LVN

    4 weeks ago

    Katy, Texas, United States Aveanna Full time

    Aveanna Healthcare Private Duty Nurse - LVN/LPNWe are seeking a compassionate and skilled Private Duty Nurse - LVN/LPN to join our team at Aveanna Healthcare. As a Private Duty Nurse, you will provide one-on-one care to our patients in their homes, assisting them with transitioning from the hospital and providing continuous care to remain at home with their...

  • Senior IT Quality Assurance and Business Analyst

    3 weeks ago

    Katy, Texas, United States CyberTec Full time

    Job Title: Senior IT Quality Assurance and Business AnalystJob Summary:We are seeking a highly skilled Senior IT Quality Assurance and Business Analyst to join our team at CyberTec. The ideal candidate will have a strong background in IT quality assurance and business analysis, with a proven track record of delivering high-quality results in a fast-paced...

  • Full-Time LMFT, LPC, and/or LCSW Clinician

    4 weeks ago

    Katy, Texas, United States Ellie Mental Health- Katy, Texas Full time

    Job DescriptionJoin our team of dedicated mental health professionals at Ellie Mental Health - Katy, Texas, where we prioritize clinician well-being and client access to quality care. As a Full-Time Therapist, you will be part of a dynamic team driven by our core values of authenticity, humor, compassion, creativity, acceptance, and...

  • Senior IT Quality Assurance and Business Analyst

    4 weeks ago

    Katy, Texas, United States CyberTec Full time

    Job Title: Senior IT Quality Assurance and Business AnalystJob Summary: We are seeking a highly skilled Senior IT Quality Assurance and Business Analyst to join our team at CyberTec. The ideal candidate will have a strong background in IT quality assurance and business analysis, with experience in developing and implementing quality management systems and...

  • Residential Estimator

    3 weeks ago

    Katy, Texas, United States G&A Partners Full time

    At G&A Partners, we are seeking a skilled Residential Estimator to join our team. As a key member of our construction team, you will be responsible for reviewing blueprints, specifications, and related documents to calculate project costs and build project estimates.The ideal candidate will have 5-7 years of experience in estimating large residential...

  • Soccer Development Program Coordinator

    3 weeks ago

    Katy, Texas, United States Super Soccer Stars Coaching Full time

    We are Super Soccer Stars, the nation's premier progressive soccer development program. Our mission is to educate and inspire the next generation of soccer players through our one-of-a-kind curriculum.Key Responsibilities:Build and manage mutually beneficial relationships with schools, recreation departments, community centers, parks, and other facilities...

  • Fabrication Coordinator

    3 weeks ago

    Katy, Texas, United States DXP Enterprises Full time

    Role Summary:As a Fabrication Coordinator at DXP Enterprises, you will play a vital role in ensuring the smooth operation of our fabrication shop. Your primary responsibility will be to coordinate the fabrication process, from receiving customer orders to delivering finished products. This role requires strong communication and organizational skills, as well...

  • Private Duty Nurse RN

    4 weeks ago

    Katy, Texas, United States Aveanna Healthcare Full time

    Aveanna Healthcare Private Duty Nurse RNRequisition #:191578Location:Katy, TX 77449Category:NursingSalary:$35.00 per hourAveanna's Private Duty nurses assist our patients with transitioning home from the hospital and provide the continuous care needed to remain at home with their loved ones.We match our nurses to their patients based on skill, age, health...