Houston Methodist
From Houston Methodist's careers page
Status: listed on the employer's own careers page when we last checked (daily). Confirm on their site before applying.
At Houston Methodist, the Case Manager (CM) position is a registered nurse (RN) responsible for comprehensively assessing clinical condition and planning for case management, which includes care transitions and discharge planning of a targeted patient population on a designated unit(s) and/or service lines. This position works with the physicians and multidisciplinary healthcare team to facilitate clinical care coordination and maintain compassionate, efficient, quality and safe patient care and achievement of desired treatment outcomes. The CM position holds joint accountability with the social worker for discharge planning, coordination of care, and throughput, assuring that admission and continued stay are medically necessary. This position communicates clinical information to payors and post-acute care providers to ensure safe transition and continuity of care.

FLSA STATUS Exempt
Graduate of education program approved by the credentialing body for the required credential(s) indicated below in the Certifications, Licenses and Registrations section.
Bachelor’s degree preferred
Three years hospital nursing clinical experience
Acute care case management experience preferred
RN - Registered Nurse - Texas State Licensure - Texas Board of Nursing_PSV Compact Licensure – Must obtain permanent Texas license within 60 days (if establishing Texas residency)
KNOWLEDGE 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 co-workers in a manner consistent with a customer service focus and application of positive language principles
Knowledge of Medicare, Medicaid and Managed Care requirements
Progressive knowledge of community resources, healthcare financial and payor requirements/issues, and eligibility for state, local and federal programs
Progressive knowledge of discharge planning, utilization management, case management, performance improvement and managed care reimbursement
Understanding of pre-acute and post-acute venues of care and post-acute community resources
Ability to work independently and exercise sound judgment in interactions with physicians, payors, and patients and their families
Well versed in computer skills of the entire Microsoft Office Suite (Excel, Outlook, PowerPoint and Word)
Strong assessment, organizational and problem-solving skills
PEOPLE ESSENTIAL FUNCTIONS
Communicates in an active, positive and effective manner to all healthcare team members and reports pertinent clinical patient care and family data in a comprehensive and unbiased manner; listens and responds to the ideas of others. Supports patients and families in preventing/resolving clinical or ethical issues.
Collaborates with staff from the multidisciplinary care team concerning the discharge plan to improve outcomes and the safe transition of care. Uses a structured format for regular communication with patients and families.
Communicates effectively with physicians, multidisciplinary care team, patients, and families to ensure safe and timely transitions of care.
Contributes towards improvement of employee engagement as reflected by department scores, i.e., peer-to-peer accountability.
SERVICE ESSENTIAL FUNCTIONS
Assesses all patients timely, per policy, and thoroughly. Reviews chart for medical necessity and facilitation of throughput and appropriate utilization of inpatient resources and services, etc. Initiates and facilitates referrals and transfers for home health care, hospice, durable medical equipment, and other post-acute services.
Participates and is prepared to present barriers to efficient patient throughput in daily multi-disciplinary rounds (MDRs). Escalates appropriate discharge barriers to leadership and/or physician advisor.
Facilitates discharge planning activities for assigned patients and collaborates with other members of the multidisciplinary care team, as well as patient and family, on clinically complex care transitions and discharges. Maintains ownership of the discharge planning process on assigned units.
QUALITY/SAFETY ESSENTIAL FUNCTIONS
Modifies care based on continuous evaluation of the patient’s medical condition and progression. Demonstrates clinical problem-solving and critical thinking within the scope of practice and makes decisions using an evidence-based analytical approach. Documents accurate assessment and interventions efficiently and effectively.
Educates patient and family appropriately on disease process that impacts their health and readmission. Connects patient and family with resources related to their disease process.
Proactively plans for routine discharge, elevates emergent situations, and escalates unresolved barriers. Manages usual patient assignment and other unit demands, anticipating/planning for potential problems.
Focuses on discharge domain by contributing to department and hospital targets for quality, patient satisfaction and safety measures.
FINANCE ESSENTIAL FUNCTIONS
Focuses on reducing length of stay for all levels of care, (inpatient, observation and outpatient in a bed) and avoidable days by ensuring efficient and timely use of resources in discharge planning and transitions. Reviews medical records for medical necessity for continued stay, facilitate timely discharge to reduce discharge delays.
Applies knowledge of payor requirements and coverage to facilitate cost-effective discharges. Contributes to meeting department and hospital financial targets. Utilizes resources with cost effectiveness and value creation in mind. Self-motivated to independently manage time effectively and prioritize daily tasks, assisting coworkers as needed.
GROWTH/INNOVATION ESSENTIAL FUNCTIONS
Identifies areas for process improvement based on understanding of evidence-based practice literature. Participates in evidence-based practice/performance improvement projects based on these observations and offers solutions.
Seeks opportunities to identify self-development needs and takes appropriate action. Ensures own career discussions occur with appropriate management. Completes and updates the My Development Plan on an ongoing basis.
SUPPLEMENTAL REQUIREMENTS
WORK ATTIRE
Uniform: No
Scrubs: No
Business professional: Yes
Other (department approved): No
ON-CALL*
Note that employees may be required to be on-call 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

 Work Shift: 1 - Day (United States of America)

 Job Category: Clinical

Houston Methodist The Woodlands Hospital opened in June 2017. This 725,000-square-foot, full-service, acute-care hospital offers many of the same services as our flagship hospital in the Texas Medical Center. Also, on the beautiful hospital campus, located at the intersection of Interstate 45 and Texas State Highway 242, are two medical office buildings, which include a Breast Care Center; Cancer Center; infusion center; heart and vascular services; neurology; orthopedics and sports medicine; rehabilitation services; wellness services; an outpatient laboratory; and several other multispecialty physician practices. In January 2022, Houston Methodist The Woodlands opened Healing Tower — a $250 million expansion project that added 106 beds, focused on medical-surgical and women’s services, and provided nine operating rooms. The project also included the expansion of the endoscopy center, emergency department and diagnostic imaging department with an enhanced neurodiagnostic and interventional center.
 Houston Methodist is an Equal Opportunity Employer.
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