manager case management

HCA Florida Gainesville Hospital

<div><h5 class="jobSectionHeader">Introduction</h5>
Last year our HCA Healthcare colleagues invested over 156,000 hours volunteering in our communities. As a(an) Manager Case Management with HCA Florida Gainesville Hospital you can be a part of an organization that is devoted to giving back!<h5 class="jobSectionHeader">
Benefits</h5>
HCA Florida Gainesville Hospital offers a total rewards package that supports the health, life, career and retirement of our colleagues. The available plans and programs include:<ul><li>
Comprehensive medical coverage that covers many common services at no cost or for a low copay. Plans include prescription drug and behavioral health coverage as well as free telemedicine services and free AirMed medical transportation.</li><li>
Additional options for dental and vision benefits, life and disability coverage, flexible spending accounts, supplemental health protection plans (accident, critical illness, hospital indemnity), auto and home insurance, identity theft protection, legal counseling, long-term care coverage, moving assistance, pet insurance and more.</li><li>
Free counseling services and resources for emotional, physical and financial wellbeing 
</li><li>
401(k) Plan with a 100% match on 3% to 9% of pay (based on years of service) 
</li><li>
Employee Stock Purchase Plan with 10% off HCA Healthcare stock 
</li><li>
Family support through fertility and family building benefits with Progyny and adoption assistance. 
</li><li>
Referral services for child, elder and pet care, home and auto repair, event planning and more 
</li><li>
Consumer discounts through Abenity and Consumer Discounts 
</li><li>
Retirement readiness, rollover assistance services and preferred banking partnerships 
</li><li>
Education assistance (tuition, student loan, certification support, dependent scholarships) 
</li><li>
Colleague recognition program 
</li><li>
Time Away From Work Program (paid time off, paid family leave, long- and short-term disability coverage and leaves of absence) 
</li><li>
Employee Health Assistance Fund that offers free employee-only coverage to full-time and part-time colleagues based on income.</li></ul>
Learn more about Employee Benefits
Note: Eligibility for benefits may vary by location. 
Would you like to unlock your potential with a leading healthcare provider dedicated to the growth and development of our colleagues? Join the HCA Florida Gainesville Hospital family! We will give you the tools and resources you need to succeed in our organization. We are looking for an enthusiastic Manager Case Management to help us reach our goals. Unlock your potential!<h5 class="jobSectionHeader">
Job Summary and Qualifications</h5>
Job Summary:
Assists in the overall coordination of hospital-wide case management functions including assessment, improvement activities, regulatory and accreditation surveys and compliance, appropriate admissions/status, and length of stay. Acts on behalf of the Director in his/her absence. Responsible for assisting with the oversight of staffing schedules, productivity standards, employee competency documentation, annual performance appraisals, performance improvement programs, staff education and special projects as assigned.<h6 class="jobSectionHeader"> 
What qualifications you will need:</h6><ul><li>
Currently licensed as a registered professional nurse in the state(s) of practice and/or has an active compact license, in accordance with law and regulation.
</li><li>Bachelor&rsquo;s Degree in Nursing (BSN) required.</li><li>
5+ years related experience required.
</li><li>Demonstrated success and abilities in leadership, achieving results, communications, customer service and health care management.</li></ul>
About HCA Florida Gainesville Hospital
HCA Florida Gainesville Hospital, opening Spring 2026, is a 90-bed, state-of-the-art acute care facility offering comprehensive emergency services, advanced surgical care, and a 30-bed inpatient rehabilitation unit. As part of HCA Florida Healthcare and the broader HCA Healthcare network of 650+ sites, we are committed to improving more lives in more ways and serving the Gainesville community.
Key Specialties<ul><li>
Emergency Medicine &ndash; Comprehensive emergency care services</li><li>
Orthopedic Surgery &ndash; Advanced procedures for bones, joints, and musculoskeletal conditions</li><li>
Spine Surgery &ndash; Specialized care for spinal disorders and injuries</li><li>
General Surgery &ndash; Full range of surgical treatments for diverse conditions</li><li>
Minimally Invasive Surgery &ndash; Laparoscopic and robotic techniques for faster recovery and reduced complications</li><li>
Inpatient Rehabilitation &ndash; 30-bed unit for post-surgical and injury recovery</li></ul>
Why Join Us<ul><li>
Be part of a brand-new, state-of-the-art hospital opening in Spring 2026</li><li>
Work with cutting-edge technology and innovative surgical techniques</li><li>
Join a collaborative, patient-centered team committed to excellence</li><li>
Access career growth opportunities within HCA Healthcare&rsquo;s nationwide network</li><li>
Make a difference in the Gainesville community while advancing your career</li></ul>
Join us in shaping the future of healthcare in Gainesville. Apply now and become part of HCA Florida Healthcare&rsquo;s mission to improve more lives in more ways. 
&quot;There is so much good to do in the world and so many different ways to do it.&quot;- Dr. Thomas Frist, Sr. 
HCA Healthcare Co-Founder
Be a part of an organization that invests in you! We are reviewing applications for our Manager Case Management opening. Qualified candidates will be contacted for interviews. Submit your application and help us raise the bar in patient care!
We are an equal opportunity employer. We do not discriminate on the basis of race, religion, color, national origin, gender, sexual orientation, age, marital status, veteran status, or disability status.</div>

Manager Case Management

Baptist Health South Florida

<div>Baptist Health is the region&rsquo;s largest not-for-profit healthcare organization, with 12 hospitals, over 28,000 employees, 4,500 physicians and 200 outpatient centers, urgent care facilities and physician practices across Miami-Dade, Monroe, Broward and Palm Beach counties. With internationally renowned centers of excellence in cancer, cardiovascular care, orthopedics and sports medicine, and neurosciences, Baptist Health is supported by philanthropy and driven by its faith-based mission of medical excellence. For 25 years, we&rsquo;ve been named one of Fortune&rsquo;s 100 Best Companies to Work For, and in the 2024-2025 U.S. News &amp; World Report Best Hospital Rankings, Baptist Health was the most awarded healthcare system in South Florida, earning 45 high-performing honors.
What truly sets us apart is our people. At Baptist Health, we create personal connections with our colleagues that go beyond the workplace, and we form meaningful relationships with patients and their families that extend beyond delivering care. Many of us have walked in our patients&rsquo; shoes ourselves and that shared experience fuels out commitment to compassion and quality. Our culture is rooted in purpose, and every team member plays a part in making a positive impact &ndash; because when it comes to caring for people, we&rsquo;re all in.<h2 class="jobSectionHeader">
Description:</h2> 
Intervenes with patients/families for psychosocial needs, assistance, support in coping with chronic acute terminal illness. Services may include: consultation discharge planning, education, counseling, advocacy, info referrals to meet the emotional social, financial aspects of care. Provides crisis intervention to patients/families with psychosocial needs. Coordinates/Facilitates development of a discharge plan of care. Provides patient/family services via case finding referrals from physicians and healthcare team members. Serves as an expert and acts as a liaison between patients and community resources. Identifies patient and family psycho-social and environmental needs related to admission, diagnosis, treatment and discharge. Works collaboratively with other members of the interdisciplinary team in developing and implementing a comprehensive discharge plan. Makes appropriate referrals for to community services, may provide inpatient emotional support and counseling, crisis intervention, and bereavement services. Assesses and intervenes in situations involving child or elder abuse/neglect, domestic violence. Provides care and services to all patient groups: neonatal, infant, pediatric, adolescent, and adults. Estimated pay range for this position is $37.25 / hour depending on shift as applicable.<h2 class="jobSectionHeader">
Qualifications:</h2> 
Degrees:
<ul><li>Masters.</li></ul>
Additional Qualifications:
<ul><li>Masters in Social Work (MSW).</li><li>
Demonstrate ability to solve problems in a fast-paced environment.</li><li>
0-1 years of social work experience in hospital or related health care setting, Emergency Department experience preferred.</li><li>
Internship will be considered as experience.</li><li>
Excellent interpersonal communication and negotiation skills.</li><li>
Strong analytical, data management and computer skills.</li><li>
Current working knowledge of discharge planning, crisis intervention, complex case management and performance improvement preferred.</li><li>
Strong working knowledge of community services available for insured and non-insured patients.</li><li>
Strong organizational and time management skills, as evidenced by capacity to prioritize multiple tasks and role components.</li><li>
Ability to work independently and exercise sound judgment.</li><li>
Ability to prioritize and manage multiple high-risk, complex patients.</li><li>
Ability to work with multiple members of a care team and maintain positive working relationships.</li></ul>
Minimum Required Experience: Less than 1 year 
EOE, including disability/vets</div>

Social Work Case Manager, Case Management

Olympia Fields Hospital

<div>Responsibilities:
<div>
The working Manager of Case Management is responsible for the development of staff and systems to effectively operate a comprehensive Case Management Program. Provides leadership and supervision to case managers, social workers, case management coordinators/discharge planners, utilization review coordinators and utilization review technicians. Assesses needs and plans, communicates and designs services that are appropriate to the hospital mission and patient/family needs. Integrates and coordinates services using continuous quality improvement tools. Responsible for the quality and resource management of all patients that are admitted to the facility from the point of their admission and across the continuum of the health care management. The methodology is designed to facilitate and insure the achievement of quality, clinical and cost effective outcomes and to perform a holistic and comprehensive admission and concurrent review of the medical record for the medical necessity, intensity of service and severity of illness.</div>
Qualifications:
<div>
EDUCATION, EXPERIENCE, TRAINING</div><div></div><div> 
Required qualifications:</div><ul><li>
Licensed clinician in your state.</li><li>
Grandfathered prior to April 1, 2015. Minimum 5 years&rsquo; post graduate of an accredited school of Social Work for Licensed Clinical Social Worker.</li><li>
Minimum 5 years&rsquo; experience in a Case Management position.</li><li>
Must have analytical ability for problem identification and assessment and evaluation of data/statistics obtained from an on-going review process.</li><li>
Experience and knowledge in basic to intermediate computer skills.</li></ul><div>
Preferred qualifications:</div><ul><li>
Certification in Case Management, BS or BSN or related field preferred.</li><li>
Current BCLS certificate preferred.</li><li>
Knowledge of Milliman Criteria and InterQual Criteria preferred.</li></ul><div></div><div> 
The company is dedicated to empowering its staff with a comprehensive, competitive benefits package, allowing them the freedom to customize their benefits to fit their unique needs. Our abundant resources, programs, and voluntary options serve as a foundation for individual growth and well-being. Learn more here: https://www.primehealthcare.com/benefitsthatmattermost/</div>
Pay Transparency:
<div>
Olympia Fields Hospital offers competitive compensation and a comprehensive benefits package that provides employees the flexibility to tailor benefits according to their individual needs. Our Total Rewards package includes, but is not limited to, paid time off, a 401K retirement plan, medical, dental, and vision coverage, tuition reimbursement, and many more voluntary benefit options. A reasonable compensation estimate for this role, which includes estimated wages, benefits, and other forms of compensation, is $XXX,XXX.XX to $XXX,XXX.XX on an annualized basis. The exact starting compensation to be offered will be determined at the time of selecting an applicant for hire, in which a wide range of factors will be considered, including but not limited to, skillset, years of applicable experience, education, credentials and licensure.</div><div></div><div> 
The company is dedicated to empowering its staff with a comprehensive, competitive benefits package, allowing them the freedom to customize their benefits to fit their unique needs. Our abundant resources, programs, and voluntary options serve as a foundation for individual growth and well-being. Learn more here: https://www.primehealthcare.com/benefitsthatmattermost/</div>
Employment Status: Full Time Shift: Days Equal Employment Opportunity:
<div>
Company is an equal employment opportunity employer. Company prohibits discrimination against any applicant or employee based on race, color, sex, sexual orientation, gender identity, religion, national origin, age (subject to applicable law), disability, military status, genetic information or any other basis protected by applicable federal, state, or local laws. The Company also prohibits harassment of applicants or employees based on any of these protected categories. Know Your Rights: https://www.eeoc.gov/sites/default/files/2022-10/EEOC_KnowYourRights_screen_reader_10_20.pdf</div></div>

Manager of Case Management

Hendrick Health

•
 <ul>
<li>The Registered Nurse (RN) Case Manager (CM) is responsible for coordinating the care and service of selected patient populations through the acute care episode transitioning the patient across the continuum. The CM works collaboratively with interdisciplinary teams; both internal and external to Hendrick Medical Center (HMC); to improve patient care through effective utilization and monitoring of healthcare resources. The CM assumes a leadership role to achieve desired clinical; financial; and resource outcomes.</li>
<li>JOB REQUIREMENTS</li>
<li>Minimum Education</li>
<li>Graduate of an accredited School of Nursing</li>
<li>Minimum Work Experience</li>
<li>3 years clinical experience as a staff nurse in an acute care hospital with Charge/Nurse Manager experience beneficial</li>
<li>Required Licenses/Certifications</li>
<li>Registered Nurse</li>
<li>Certification through Commission for Case Manager (CCM) or American Case Management Association (ACMA) within 2 years of hire</li>
<li>BLS</li>
<li>Required Skills; Knowledge; and Abilities</li>
<li>Ability to demonstrate advanced communication and interpersonal skills with all levels of internal and external customers; including but not limited to medical staff; patients and families; clinical personnel; support and technical staff; external agencies; and members of the community</li>
<li>Ability to engage in complex clinical decision-making</li>
<li>Ability to show strong commitment to interdisciplinary collaboration and communication</li>
<li>Ability to demonstrate strong computer skills</li>
<li>Ability to demonstrate strong critical thinking and analysis skills and conflict resolution skills</li>
<li>Ability to demonstrate excellent human relations skills</li>
<li>Ability to show creative problem solving.</li>
<li>Ability to be proficient with organization and planning</li>
<li>Ability to show initiative and work with no supervision</li>
<li>Ability to tolerate frequent interruptions and demanding workload</li>
<li>Proficient in Allscripts EMR; Allscripts CM software program; Milliman Care Guidelines (MCG); IDX and 3M within 6 months</li>
<li>Designated Driver</li>
<li>No</li>
<li>OSHA Category</li>
<li>2 - Medium Risk</li>
</ul>

Case Manager (RN), Case Management

Fresenius Medical Care

<div></div><div><div>PURPOSE AND SCOPE:
Manages a team that promotes quality patient care, ongoing patient support and case management for Fresenius Medical Care (FMCNA) renal patient population (internal and external) through staff with the provision of guidance, subject matter expertise, training and support to assigned telephonic staff. Collaborates with clinical staff to assist the patient in making informed decisions, regarding dialysis and insurance issues.
PRINCIPAL DUTIES AND RESPONSIBILITIES:<ul><li>
Provides oversight to the daily operations of assigned team, including but not limited to, establishing mutual goals, maintaining schedules, checking work at frequent intervals and assigning tasks and duties to improve and promote teamwork for overall department and individual growth.</li><li>
Provides subject matter expertise, leadership, support and guidance to assigned staff regarding procedures, issues and problems, ensuring appropriate application and resolution.
</li><li>Leverages team to identify, analyze, plan, organize and develop new workflow processes and/or modifies existing processes as appropriate to meet the program requirements, improve quality of care, reduce health care costs, and enhance / support the patient&rsquo;s health care or insurance needs.
</li><li>Provides strategic guidance with development of outcome and productivity reports and prepares other pertinent statistical reports noting trends and issues.
</li><li>Acts as a liaison for clinical stakeholders to address and resolve patient concerns or issues.
</li><li>Oversees caseload assignments based on patient /clinic volume and licensure requirements. Ensures team meetings compliance with state RN licenses to meet business needs.
</li><li>Utilizes evidenced based and best demonstrated practices to address barriers to quality improvement. This includes promoting the adoption and utilization of Corporate Medical Advisory Board Recommended Algorithms and Standing Orders, clinical pathways and clinical policies and procedures to improve care coordination and delivery.</li><li>
Responsible for offering staff education and development opportunities in partnership with the case management leadership, facilitates meetings and hosts staff meetings.</li><li>
Creates and provides presentations to clinical and case management staff, as appropriate.</li><li>
May be assigned a patient load depending on volume and need.
</li><li>Performs other related duties as assigned.</li></ul>
PHYSICAL DEMANDS AND WORKING CONDITIONS:<ul><li>
The physical demands and work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.<ul><li>
This job operates in an office setting. While performing the duties of this job, the employee is regularly required to talk and hear. This role routinely and frequently uses a desk and standard office equipment such as computers, phones, and photocopiers with repetitive motion.</li><li>
This position requires approximately 0% to 10% travel.</li></ul></li></ul>
SUPERVISION:<ul><li>
Responsible for the direct supervision of various levels of telephonic staff.</li></ul>
EDUCATION AND REQUIRED CREDENTIALS:<ul><li>
Bachelor&rsquo;s Degree; Advanced Degree desirable or an equivalent combination of education and experience</li><li>
BSN required with active unrestricted nursing licensure in practicing state &ndash; with the ability to obtain licensure in multiple states.</li><li>
Certified Case Manager (CCM) required.</li><li>
Certification in nephrology specialty (CNN, CDN) a plus.</li></ul>
EXPERIENCE AND SKILLS:
<ul><li>8 &ndash; 10 years&rsquo; related experience or an equivalent combination of education and experience.</li><li>
3+ years&rsquo; experience as a Manager preferred.</li><li>
Demonstrated ability to manage one or more departments.
</li><li>Must exhibit management/leadership skills and be able to work with and influence staff in the clinics.</li><li>
Must have knowledge of teaching-learning process, principles, and methods of adult education.</li><li>
Must be self-motivated and able to plan a diversity of activities and work independently.</li><li>
Ability to function as a part of an integrated team.
</li><li>Ability to follow oral and written communication and communicate information to individuals or groups with varying levels of education.</li><li>
Excellent communication, verbal and written, and customer service skills.
</li><li>Organized and detail oriented.</li><li>
Must exhibit practical computer skills such as e-mail, Word documents, and basic Excel spreadsheet skills. PowerPoint skills are preferred. Must be able to type proficiently.</li></ul>
The rate of pay for this position will depend on the successful candidate&rsquo;s work location and qualifications, including relevant education, work experience, skills, and competencies. 
 
Rate: $XX - $XX 
 
Non-Bonus Eligible Positions: include language below. 
 
Benefit Overview: This position offers a comprehensive benefits package including medical, dental, and vision insurance, a 401(k) with company match, paid time off, parental leave. 
 
Bonus Eligible Positions &ndash; include language below. 
 
Benefit Overview: This position offers a comprehensive benefits package including medical, dental, and vision insurance, a 401(k) with company match, paid time off, parental leave and potential for performance-based bonuses depending on company and individual performance
Fresenius Medical Care maintains a drug-free workplace in accordance with applicable federal and state laws.</div>
EOE, disability/veterans</div>

Sr Manager Telephonic Case Management

CHRISTUS Health

<div>Description 
CHRISTUS Santa Rosa Hospital - New Braunfels (CSRH-NB), nestled in the heart of downtown New Braunfels, is a full-service, 94-private bed facility that continues to expand to meet the needs of New Braunfels&rsquo; strong population growth. Innovative equipment and procedures are utilized, including an Outpatient Imaging Center, orthopedic and surgical services, rehabilitation, a renovated birthing center, including 24/7 neonatal coverage, emergency care, wound care/hyperbaric center, 3D mammography, and comprehensive heart care, from diagnostics to open-heart surgery.
Summary:
The Care Manager (CM) II works in collaboration with the patient/family, physicians and multidisciplinary team members to ensure patient progression through the continuum of care and to develop a plan of care for each assigned patient from admission through discharge. The CM is responsible for identifying, initiating and managing optimal patient flow/throughput to enhance continuity of care, smooth and safe transitions, patient satisfaction, patient safety, and length of stay management. Support and expertise are provided through comprehensive assessment, planning, implementation, and overall evaluation of individual patient needs. Care Coordination and Discharge Planning are both responsibilities of this role. The CM assesses and responds to patient/family needs by coordinating efforts of other team members and identifies and resolves barriers that hinder effective patient care. The CM adheres to departmental and organizational goals, objectives, standards of performance, policies and procedures, and continually assures regulatory compliance.
Responsibilities: 
<ul><li>Meets expectations of the applicable OneCHRISTUS Competencies: Leader of Self, Leader of Others, or Leader of Leaders.</li><li>
Coordinates the integration of case management functions into the patient care and discharge planning processes in collaboration with other hospital departments, external service organizations, agencies, and healthcare facilities.</li><li>
Coordinates/facilitates patient care progression throughout the continuum of care in an efficient and cost-effective manner.</li><li>
Serves as resource, provides support, and advocates on behalf of the patient related to treatment decisions and end of life issues.</li><li>
Closely monitor patient length of stay in regard to the geometric mean length of stay and communicate/collaborate with appropriate interdisciplinary team members to remove barriers and expedite discharge.</li><li>
Implements and monitors the patient&rsquo;s plan of care to ensure effectiveness and appropriateness of services.</li><li>
Identifies and escalates local and system barriers that are impeding diagnostic or treatment progress and issues related to quality and risk as appropriate in a timely manner.</li><li>
Proactively identifies and resolves delays and obstacles to discharge.</li><li>
Uses advanced conflict resolution skills as necessary to ensure timely resolution of issues.</li><li>
Collaborates with medical staff, nursing staff, and ancillary staff to eliminate barriers to efficient delivery of care in the appropriate setting.</li><li>
Interviews patients/families to obtain information about social, emotional, and financial factors which impact health status to develop comprehensive discharge planning assessment and care plan.</li><li>
Assesses needs for discharge planning and continuing care/resource support following discharge; independently makes recommendations to patients and families regarding post-acute level of care needs and options including: 
<ul><li>Acute Rehabilitation Placement</li><li>
Nursing Home or Skilled Nursing placement</li><li>
Psychiatric or Substance Abuse placement</li><li>
New Dialysis</li><li>
Child/Adult/Domestic Abuse</li><li>
Home Health/Hospice Referrals</li><li>
Legal issues (adoptions, guardianship)</li><li>
Assistance with Advance Directives</li><li>
Community Resource needs</li><li>
Financial Issues/Funding options</li><li>
DME Referrals and Coordination</li><li>
Social Determinants of Health</li></ul></li><li>
Initiates discharge planning at the time of admission and makes post-hospital service referrals based upon information gathered during assessment and interactions with physicians, multidisciplinary care team, and payors as indicated.</li><li>
Acts as patient advocate by negotiating for, and coordinating, resources with payors, agencies, and vendors.</li><li>
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.</li><li>
Provide appropriate interventions which demonstrate knowledge of and sensitivity toward cultural diversity and the religious, developmental, health literacy, and educational backgrounds of the patient population.</li><li>
Assesses the patient&rsquo;s formal and informal support system as well as available benefits and/or community resources.</li><li>
Meets directly with patient/family to assess needs and develop and individualized care plan in collaboration with the physician.</li><li>
Ensures and maintains plan consensus from patient/family, physician and payor.</li><li>
Provides education, information, direction, and support related to patient&rsquo;s goals of care.</li><li>
Acts as patient advocate to develop treatment plan and coordinate patient care and to transition patient to the appropriate next level of care.</li><li>
Demonstrates and promotes respect for the dignity and rights of every patient while adhering to the safety standards and practices of the organization and the nursing profession.</li><li>
Collaborates with the physician and other health care professionals to promote appropriate use of medical center resources.</li><li>
Provides information and support to patients and families, helping them access needed resources within the medical center and community.</li><li>
Actively participates in clinical performance improvement activities involving length of stay, resource utilization, avoidable days, cost per case, and readmissions.</li><li>
Measures effectiveness of interventions through direct communication with post-acute care providers, patients, and caregivers.</li><li>
Promotes individual professional growth and development by meeting requirements for mandatory/continuing education and skills competency.</li><li>
Actively participates in Multidisciplinary/Patient Care Progression Rounds.</li><li>
Escalates cases as appropriate and per policy to Physician Advisors and/or CM Director.</li><li>
Documents in the medical record per regulatory and department guidelines.</li><li>
May be asked to assist with special projects.</li><li>
May serve a preceptor or orienter to new associates.</li><li>
Assumes responsibility for professional growth and development.</li><li>
Must have excellent verbal and written communication and ability to interact with diverse populations.</li><li>
Must have critical and analytical thinking skills.</li><li>
Must have demonstrated clinical competency.</li><li>
Must have the ability to Multitask and to function in a stressful and fast paced environment.</li><li>
Must have working knowledge of discharge planning, utilization management, case management, performance improvement, and managed care reimbursement.</li><li>
Must have understanding of pre-acute and post-acute levels of care and community resources.</li><li>
Must have ability to work independently and exercise sound judgment in interactions with physicians, payors, patients and their families.</li><li>
Must be understanding of internal and external resources and knowledge of available community resources.</li><li>
Must have the ability to move around the hospital to all areas for the majority of the workday while in office the rest of the day; general office and hospital environment.</li></ul>
Job Requirements: 
Education/Skills
<ul><li>Graduate of an accredited school of nursing (BSN preferred) or Masters Degree in Social Work (MSW) required or demonstrated success in CHRISTUS Care Manager I Position for at least 5 years on top of the required experience in lieu of education required.
</li></ul>Experience
<ul><li>Two or more years clinical experience with one year in the acute care setting preferred.
</li></ul>Licenses, Registrations, or Certifications
<ul><li>RN or LMSW in the state of employment is required for new hires.
</li><li>LBSW accepted for associates with 5+ years of demonstrated success and experience in CHRISTUS Care Manager I role.
</li><li>Certification in Case Management preferred.
</li><li>BLS preferred.</li></ul> 

Work Schedule: 
8AM - 5PM Monday-Friday
Work Type: 
Full Time</div>

Care Manager II - Case Management

<div>Description<div> 
CHRISTUS Spohn Hospital Corpus Christi - Shoreline overlooking Corpus Christi Bay is the largest and foremost acute care medical facility in the region, with a full range of diagnostic and surgical specialty services in cardiac, cancer, and stroke care. It is the leading emergency facility in the area with a Level II Trauma Center in the Coastal Bend, staffed with physicians and nurses specially trained in emergency services.</div>
<div><ul><li>The Pavilion and North Tower house a state-of-the-art emergency department, ICU, Cardiac Cath Lab and surgical suites</li><li>
A teaching facility in affiliation with the Texas A&amp;M University System Health and Science Center College of Medicine</li><li>
Accredited Chest Pain Center</li><li>
Accredited Joint Commission Stroke Team</li></ul></div>
Summary:
The Care Manager (CM) II works in collaboration with the patient/family, physicians and multidisciplinary team members to ensure patient progression through the continuum of care and to develop a plan of care for each assigned patient from admission through discharge. The CM is responsible for identifying, initiating and managing optimal patient flow/throughput to enhance continuity of care, smooth and safe transitions, patient satisfaction, patient safety, and length of stay management. Support and expertise are provided through comprehensive assessment, planning, implementation, and overall evaluation of individual patient needs. Care Coordination and Discharge Planning are both responsibilities of this role. The CM assesses and responds to patient/family needs by coordinating efforts of other team members and identifies and resolves barriers that hinder effective patient care. The CM adheres to departmental and organizational goals, objectives, standards of performance, policies and procedures, and continually assures regulatory compliance.
Responsibilities: 
<ul><li>Meets expectations of the applicable OneCHRISTUS Competencies: Leader of Self, Leader of Others, or Leader of Leaders.</li><li>
Coordinates the integration of case management functions into the patient care and discharge planning processes in collaboration with other hospital departments, external service organizations, agencies, and healthcare facilities.</li><li>
Coordinates/facilitates patient care progression throughout the continuum of care in an efficient and cost-effective manner.</li><li>
Serves as resource, provides support, and advocates on behalf of the patient related to treatment decisions and end of life issues.</li><li>
Closely monitor patient length of stay in regard to the geometric mean length of stay and communicate/collaborate with appropriate interdisciplinary team members to remove barriers and expedite discharge.</li><li>
Implements and monitors the patient&rsquo;s plan of care to ensure effectiveness and appropriateness of services.</li><li>
Identifies and escalates local and system barriers that are impeding diagnostic or treatment progress and issues related to quality and risk as appropriate in a timely manner.</li><li>
Proactively identifies and resolves delays and obstacles to discharge.</li><li>
Uses advanced conflict resolution skills as necessary to ensure timely resolution of issues.</li><li>
Collaborates with medical staff, nursing staff, and ancillary staff to eliminate barriers to efficient delivery of care in the appropriate setting.</li><li>
Interviews patients/families to obtain information about social, emotional, and financial factors which impact health status to develop comprehensive discharge planning assessment and care plan.</li><li>
Assesses needs for discharge planning and continuing care/resource support following discharge; independently makes recommendations to patients and families regarding post-acute level of care needs and options including: 
<ul><li>Acute Rehabilitation Placement</li><li>
Nursing Home or Skilled Nursing placement</li><li>
Psychiatric or Substance Abuse placement</li><li>
New Dialysis</li><li>
Child/Adult/Domestic Abuse</li><li>
Home Health/Hospice Referrals</li><li>
Legal issues (adoptions, guardianship)</li><li>
Assistance with Advance Directives</li><li>
Community Resource needs</li><li>
Financial Issues/Funding options</li><li>
DME Referrals and Coordination</li><li>
Social Determinants of Health</li></ul></li><li>
Initiates discharge planning at the time of admission and makes post-hospital service referrals based upon information gathered during assessment and interactions with physicians, multidisciplinary care team, and payors as indicated.</li><li>
Acts as patient advocate by negotiating for, and coordinating, resources with payors, agencies, and vendors.</li><li>
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.</li><li>
Provide appropriate interventions which demonstrate knowledge of and sensitivity toward cultural diversity and the religious, developmental, health literacy, and educational backgrounds of the patient population.</li><li>
Assesses the patient&rsquo;s formal and informal support system as well as available benefits and/or community resources.</li><li>
Meets directly with patient/family to assess needs and develop and individualized care plan in collaboration with the physician.</li><li>
Ensures and maintains plan consensus from patient/family, physician and payor.</li><li>
Provides education, information, direction, and support related to patient&rsquo;s goals of care.</li><li>
Acts as patient advocate to develop treatment plan and coordinate patient care and to transition patient to the appropriate next level of care.</li><li>
Demonstrates and promotes respect for the dignity and rights of every patient while adhering to the safety standards and practices of the organization and the nursing profession.</li><li>
Collaborates with the physician and other health care professionals to promote appropriate use of medical center resources.</li><li>
Provides information and support to patients and families, helping them access needed resources within the medical center and community.</li><li>
Actively participates in clinical performance improvement activities involving length of stay, resource utilization, avoidable days, cost per case, and readmissions.</li><li>
Measures effectiveness of interventions through direct communication with post-acute care providers, patients, and caregivers.</li><li>
Promotes individual professional growth and development by meeting requirements for mandatory/continuing education and skills competency.</li><li>
Actively participates in Multidisciplinary/Patient Care Progression Rounds.</li><li>
Escalates cases as appropriate and per policy to Physician Advisors and/or CM Director.</li><li>
Documents in the medical record per regulatory and department guidelines.</li><li>
May be asked to assist with special projects.</li><li>
May serve a preceptor or orienter to new associates.</li><li>
Assumes responsibility for professional growth and development.</li><li>
Must have excellent verbal and written communication and ability to interact with diverse populations.</li><li>
Must have critical and analytical thinking skills.</li><li>
Must have demonstrated clinical competency.</li><li>
Must have the ability to Multitask and to function in a stressful and fast paced environment.</li><li>
Must have working knowledge of discharge planning, utilization management, case management, performance improvement, and managed care reimbursement.</li><li>
Must have understanding of pre-acute and post-acute levels of care and community resources.</li><li>
Must have ability to work independently and exercise sound judgment in interactions with physicians, payors, patients and their families.</li><li>
Must be understanding of internal and external resources and knowledge of available community resources.</li><li>
Must have the ability to move around the hospital to all areas for the majority of the workday while in office the rest of the day; general office and hospital environment.</li></ul>
Job Requirements: 
Education/Skills
<ul><li>Graduate of an accredited school of nursing (BSN preferred) or Masters Degree in Social Work (MSW) required or demonstrated success in CHRISTUS Care Manager I Position for at least 5 years on top of the required experience in lieu of education required.
</li></ul>Experience
<ul><li>Two or more years clinical experience with one year in the acute care setting preferred.
</li></ul>Licenses, Registrations, or Certifications
<ul><li>RN or LMSW in the state of employment is required for new hires.
</li><li>LBSW accepted for associates with 5+ years of demonstrated success and experience in CHRISTUS Care Manager I role.
</li><li>Certification in Case Management preferred.
</li><li>BLS preferred.</li></ul> 

Work Schedule: 
MULTIPLE SHIFTS AVAILABLE
Work Type: 
Part Time</div>

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