patient case manager

Select Medical

<div>Overview:
<div><b>
Select Medical Madison Rehabilitation Hospital</b></div><div><b>
*A joint venture with Select Medical &amp; Hospital*</b></div><div>
Madison, Wisconsin</div><div></div><div><b><br>
Case Manager (RN, SW, RT, LPN)</b></div><div></div><div><b><br>
M-F 8HR Shifts *As Needed Basis*</b></div><div></div><div><b><br>
Why Join Us?</b></div><ul><li><b>
Start Strong</b>: Extensive and thorough orientation program to ensure a smooth transition into our setting</li><li><b>
Recharge &amp; Refresh</b>: Generous PTO and Paid Sick Time for full-time team members to maintain a healthy work-life balance</li><li><b>
Your Health Matters</b>: Comprehensive medical/RX, health, vision, employee assistance program (EAP) and dental plan offerings for full-time team members</li><li><b>
Invest in Your Future:</b> Company-matching 401(k) retirement plan, as well as life and disability protection for full-time team members</li><li><b>
Your Impact Matters:</b> Join a team of over 44,000 committed to providing exceptional patient care</li></ul>
Responsibilities:
<div><b>
Position Summary</b></div><div></div><div><br>
The Case Manager is responsible for the coordination of health care decisions by using a systematic approach to assure treatment plans that improve quality and outcomes, coordination of care across the continuum; promotion of cost-effective care within the allotted time frame; assuring payments of hospital-based services meeting patient-related utilization management criteria, and implementation of safe and appropriate discharge plans. The Case Manager assesses the psychosocial needs of the patient and provides intervention as part of the discharge planning process.</div><div><br>
</div><div>The primary job functions in Case Management include:</div><ul><li>
Clinical Interventions/Discharge Planning</li><li>
Care Planning Management</li><li>
Fiscal Management</li><li>
Payer/Referral Management</li></ul>
Qualifications:<div></div><div><b><br>
Minimum Qualifications</b></div><ul><li>
Current Licensure per sate guidelines in a clinical or related discipline OR a Bachelor's or Master's in health or human services discipline.</li></ul><div><b>
Previous Experience</b></div><ul><li>
Previous experience in Case Management and Discharge Planning preferred.</li><li>
CCM Certification Preferred.</li></ul><br>
<div></div>
Additional Data:
<div><i>
Equal Opportunity Employer/including Disabled/Veterans</i></div></div>

Case Manager - Inpatient Rehab

AHMC Healthcare

<div>Overview:
<div><b>
JOB SUMMARY:</b> The Case Manager uses InterQual criteria to evaluate the appropriateness of admissions, concurrent stay and readiness for discharge. She/he assures correct level of care: critical, telemetry, acute, observation, for all patients. The Case Manager provides an efficient, coordinated approach to clinical management, with an emphasis on discharge planning, care coordination and utilization management activities for select patient populations across the continuum of programs and services at GMC. The essential functions of the Case Manager require constant collaboration with the Social Workers, Nursing staff, Financial Counselors, Medical Staff to coordinate the care of patients in a proactive manner.
</div><div>The position requires the full understanding and active participation in fulfilling the mission of GMC - Garfield Medical Center. It is expected that the employee demonstrate behavior consistent with the core values. The employee shall support GMC - Garfield Medical Center strategic plan and goals and direction of the performance improvement plan.</div><div></div><div><b><br>
EDUCATION, EXPERIENCE, TRAINING</b></div><br>
<div></div><ul><li>
RN License in the State of California required.
</li><li>Certified Case Manager preferred.</li><li>
Meets education and competency requirements for position.</li><li>
BCLS Card AHA required.</li></ul></div><div></div>

Case Manager PD Days 7:30am-6pm

Stanford Health Care

<div>0.2 FTE Part time Day - 08 Hour R2654519 Onsite 108751001 Case Management Inpatient Nursing PALO ALTO, 300 Pasteur Dr, California<p>
If you're ready to be part of our legacy of hope and innovation, we encourage you to take the first step and explore our current job openings. Your best is waiting to be discovered.</p><br>
<p></p>
Day - 08 Hour (United States of America)<p></p><p><b>
This is a Stanford Health Care job.</b><br>
<br>
<b>A Brief Overview</b><br>
Case Managers are licensed nursing professionals responsible for coordinating continuum of care and discharge planning activities for a caseload of assigned patients. Major responsibilities include coordinating all facets of a patient's admission/discharge; performing utilization review activities, including review of patient charts for timeliness of services as well as appropriate utilization of services; and ensuring optimum use of resources, service delivery, and compliance with external review agencies' requirements. Case Managers act as consultants to the clinical team, service lines, and other departments regarding patient assessment and patient care and participate in program development and quality improvement initiatives. In their role. Case Managers, by applying guidelines and collaborating with multidisciplinary teams, influence and direct the delivery and quality of patient care. A hospital-based case management system has as its primary goal to ensure the most appropriate use of services by patients and. toward that end, to avoid duplication and misuse of medical services, control costs by reducing inefficient services, and improve the effectiveness of care delivery. Objectives are to facilitate timely discharge: prompt, efficient use of resources; achievement of expected outcomes; collaborative practice; coordination of care across the continuum; and performance/quality improvement activities that lead to optimal patient outcomes. A Case Manager differs from other roles in professional nursing/health care practice in that it is not intended to provide direct patient care; rather, a Case Manager will be assigned to specific patients to ensure that the medical services and treatments required are accomplished in the most financially and clinically efficient manner. This job description covers all classifications for Case Managers within the organization. All Case Managers must meet all elements of the Essential Functions, and Qualifications.<br>
<br>
<b>Locations</b><br>
Stanford Health Care<br>
<br>
<b>What you will do</b></p><ul><li>
Coordination of Care &mdash; Complex case manager who manages each patient's transition through the system and transfers accountability to the appropriate person upon entry into another clinical service or discharge.</li><li>
Discharge Planning - - Coordinates and facilitates timely implementation of discharge plans for assigned patients with complex needs in collaboration with other interdisciplinary team members; arranges follow up care as appropriate.</li><li>
Utilization Review &ndash; Review prospectively, concurrently and retrospectively, all inpatients for appropriateness of admission, level of care, and determines appropriate length to stay. Monitors patients' length of stay and collaborates with physicians to ensure resource utilization remains within covered benefits and are appropriate in relationship to the patient's clinical and psychosocial needs; plans and implements (through multi-disciplinary meetings or rounds) strategies to reduce length of stay, reduce resource consumption, and achieve positive patient outcomes, analyzes and addresses aggregate variances as well as variances for individual patients and shares this information with staff, physicians, and administration.</li><li>
Education/Consultation- Acts as an educational resource and provides consultation to patients and their families, hospital medical personnel regarding the discharge planning process and applicable regulatory requirements; educates the staff on case management; and provides specific information related to case types.</li><li>
Lead Work- May lead the work of administrative/clinical support staff responsible for assisting with case management for an assigned patient caseload. Other - Participates in department program planning, goal setting, systems development and process improvement; participates in department and hospital committees and task forces; develops and maintains documentation of findings, discharge arrangements, and actions taken according to departmental guidelines; prepares and maintains records as required; collects, analyzes and reports on data for utilization, quality improvement, compliance, and other areas as assigned.</li><li>
Patient Assessment / Plan of Care- Functions as a resource to and collaborates with physicians, social workers, nurses, and other interdisciplinary team members to assess, plan, and coordinate patient care needs and/or performs patient assessment and develops a plan of care to assure consistent, timely, and appropriate care is provided in a patient focused manner.</li>
Quality Improvement <li>- Participates in quality improvement activities by identifying opportunities for improvement in such areas as clinical outcomes, utilization of resources and concurrent data collection; participates in clinical process improvement teams within the department, service lines, and hospital.</li>
Third-Party Reimbursement <li>- Collects, analyzes reports and reviews patient information with third-party payers to assure reimbursement for patient services/procedures. Communicates with review organizations / payers to provide requested clinical and psychosocial information to assure reimbursement.</li></ul><p><b><br>
Education Qualifications</b></p><ul><li>
Bachelor's Degree from an accredited college or university required</li><li>
Master's Degree preferred</li></ul><p><b><br>
Experience Qualifications</b></p><ul><li>
Three (3) years of progressively responsible and directly related work experience required</li></ul><p><b><br>
Required Knowledge, Skills and Abilities</b></p><ul><li>
Ability to collect and record data, evaluate data and statistics, and maintain effective reporting systems</li><li>
Ability to develop and perform patient assessment and plan of care</li><li>
Ability to monitor and assure the patient's access to the appropriate level of care; the right health care providers; and the correct setting and services to meet the patient's needs; promote coordination and continuity in patient health care</li><li>
Ability to provide age-appropriate assessments, interpretation of data, and delivery of interventions</li><li>
Ability to provide appropriate patient care and clinical information when patients are admitted, referred, transferred, or discharged</li><li>
Ability to remain knowledgeable regarding available treatments and services</li><li>
Ability to resolve conflicts and/or negotiate with others to achieve positive results; establish and maintain effective interpersonal relationships</li><li>
Ability to understand, interpret and apply complex federal and state hospital compliance laws, rules, regulations and guidelines</li><li>
Ability to work effectively with individuals at all levels of the organization</li><li>
Knowledge of available patient services and treatment</li><li>
Knowledge of current theories, principles, practices, standards, emerging technologies, techniques and approaches in the nursing profession, and the health care system, and the responsibility and accountability for the outcome of practice</li><li>
Knowledge of evaluation and assessment techniques</li><li>
Knowledge of financial processes of various private and public funding sources for health care services/procedures</li><li>
Knowledge of hospital operations, organization, systems and procedures and laws and regulations pertaining to the operation of hospitals in California</li><li>
Knowledge of medical terminology and related levels of care and treatment</li><li>
Knowledge of the full continuum of care available to patents, interrelationships of the care components, and their effective integration</li><li>
Knowledge of the models of case management, including the principles and practices of discharge planning, utilization review, and quality assurance/improvement</li><li>
Knowledge of the variables that affect the processes and outcomes of patient health care</li></ul><p><b><br>
Licenses and Certifications</b></p><ul><li>
CA-RN (Registered Nurse) required</li></ul><p></p><p><b><br>
These principles apply to ALL employees:</b><br>
<br>
<b>SHC Commitment to Providing an Exceptional Patient &amp; Family Experience</b><br>
<br>
<i>Stanford Health Care sets a high standard for delivering value and an exceptional experience for our patients and families. Candidates for employment and existing employees must adopt and execute C-I-CARE standards for all of patients, families and towards each other. C-I-CARE is the foundation of Stanford&rsquo;s patient-experience and represents a framework for patient-centered interactions. Simply put, we do what it takes to enable and empower patients and families to focus on health, healing and recovery.</i><br>
<br>
<i>You will do this by executing against our three experience pillars, from the patient and family&rsquo;s perspective:
</i></p><p></p><ul><li>Know Me: Anticipate my needs and status to deliver effective care</li><li>
Show Me the Way: Guide and prompt my actions to arrive at better outcomes and better health</li><li>
Coordinate for Me: Own the complexity of my care through coordination</li></ul><p></p><p><b>
Equal Opportunity Employer Stanford Health Care (SHC) strongly values diversity and is committed to equal opportunity and non-discrimination in</b><b> </b><b>all of</b><b> </b><b>its policies and practices, including the area of employment. Accordingly, SHC does not discriminate against any person on the basis of race, color, sex, sexual orientation or gender identity and/or expression, religion, age, national or ethnic origin, political beliefs, marital status, medical condition, genetic information, veteran status, or disability, or the perception of any of the above. People of all genders, members of all racial and ethnic groups, people with disabilities, and veterans are encouraged to apply. Qualified applicants with criminal convictions will be considered after an individualized assessment of the conviction and the job requirements.</b></p><p></p>
Base Pay Scale: Generally starting at $111.35 - $126.14 per hour<p></p><p>
The salary of the finalist selected for this role will be set based on a variety of factors, including but not limited to, internal equity, experience, education, specialty and training. This pay scale is not a promise of a particular wage.</p></div>

Case Manager (RN) - Inpatient - Relief A Status (0.2 FTE), 08-HR, Day Shift

Evoraa Holdings LLC

<div>Description:
<p><b>
Position Summary:</b></p><p>
The Case Manager plans, implements, and coordinates an array of comprehensive, individualized client services during their residency and in preparation for continuing care and safe, sober housing after discharge. The Case Manager also delivers psychoeducational and motivational enhancement instruction in group and individual settings and performs administrative duties in support of the program.</p><p><b>
Essential Duties:</b></p><ul><li>
Perform patient screening, intake, orientation, and assessment.</li><li>
Develop or refine an individualized service plan based on assessment and other collateral data; make referrals for services as identified in plans; provide or arrange for patient transportation; and follow up on referrals during residency and for at least 30 days after discharge.</li><li>
Provide individual case management sessions on a basis in conjunction with the level of care requirements and document the review in the client's record.</li><li>
Assist patients in developing motivation for recovery and engaging in recovery activities.</li><li>
Assist patients in identifying and linking to appropriate resources for immediate needs and for the next levels of continuing care, safe and sober housing, and other recovery supports,</li><li>
Conduct psychoeducational and motivation enhancement groups.</li><li>
Attends staff meetings, case conferences, and required training to coordinate with the program team and ensure the quality of care and continuity in accordance with clinical policy.</li><li>
Maintain a working relationship with agencies, community resources, and families to coordinate services for patient care; provide information on substance abuse treatment resources and services; make necessary referrals; facilitate follow-up to ensure appropriate services have been delivered.</li><li>
Other duties as assigned.</li></ul>
Requirements:
<p><b>
Education:</b></p><ul><li>
Bachelor's Degree curriculum from an accredited institution, or an equivalent combination of education and experience, is required.</li></ul><p><b>
Experience:</b></p><ul><li>
Knowledge of and experience with case management is required.</li><li>
Experience with substance abuse, mental health, health, housing, and community support services is required.</li><li>
Experience with developing rapport with substance-abusing populations and referral and support systems is strongly preferred.</li><li>
Experience managing patient services and computerized and manual records is strongly preferred.</li><li>
Experience complying with internal, local, state, and federal requirements and regulations is strongly preferred.</li></ul><p><b>
Key Competencies:</b></p><ul><li>
Must be detail oriented.</li><li>
Able to work under pressure and meet deadlines as well as be flexible and dependable.</li><li>
Strong interpersonal and analytical skills.</li><li>
Exceptional customer/client service with the ability to resolve service issues.</li><li>
In-depth knowledge of Joint Commission and DHS standards</li><li>
Use logic and reasoning to identify the strengths and weaknesses of alternative solutions, conclusions or approaches to problems.</li><li>
Ability to handle multiple priorities with a sense of urgency.</li></ul><p><b>
Work Environment:</b></p><p>
This position is an in-person/office work environment. There will be daily face-to-face interaction with staff and clients. The workday will vary, but it will often include sitting at a desk, working on a computer, meeting with clients, and completing paperwork. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.</p><p><b>
Benefits Include:</b></p><ul><li>
Medical, Dental, Vision, Life</li><li>
Employee Assistance Program</li><li>
401k Match</li><li>
Paid-Time Off</li><li>
Sick Time</li><li>
Holiday Pay</li></ul></div>

Case Manager

University of Florida

<p></p><div><div><p><b>JOB NO:</b></p>
<div>539492</div><br>
<p><b>WORK TYPE:</b></p>
<div>Staff Full-Time</div><br>
<p><b>LOCATION:</b></p>
<div>Main Campus (Gainesville, FL)</div><br>
<p><b>CATEGORIES:</b></p>
<div>Health Care Administration/Support</div><br>
<p><b>DEPARTMENT:</b></p><div>
29180300 - MD-NEUROLOGY-MOVEMENT DISORDER</div></div><br>
<div>
<div><div><div><div><b>CLASSIFICATION TITLE:</b></div>
<div>
<p>Clinical Case Manager I</p></div><br>
</div><br>
<div><div><b>CLASSIFICATION MINIMUM REQUIREMENTS:</b></div> <div>Master's degree in an appropriate area; or a bachelor's degree in an appropriate area and two years of relevant experience.</div>
</div><br>
<div><div><b>JOB DESCRIPTION:</b></div>
<div>
<p>Join the University of Florida&rsquo;s Neurology team in the Movement Disorders Division as a <b>Clinical Case Manager I</b>, where you will make a meaningful impact on patients and families navigating complex neurological conditions. The Clinical Case Manager I independently provides casework services to patients and families as indicated to address the psychosocial aspects of care regarding adjustment to illness and treatment, as well as work collaboratively with interdisciplinary staff internal and external to the organization. The Clinical Case Manager I will participate in quality improvement and evaluation processes related to patient satisfaction and patient rights and serve as an information resource for the Fixel Institute of Neurological Diseases (FIND) in the Department of Neurology.</p>
<p><b>
About this Role</b></p>
<p>
Patient Care &amp; Navigation</p>
<ul>
<li>Develop and implement individualized treatment plans aligned with patient needs</li>
<li>Provide patient navigation across care settings (inpatient, outpatient, home health, etc.)</li>
<li>Deliver education and support programming for patients and families</li>
<li>Assist with access to medications, transportation, and advance directives</li>
<li>Coordinate outreach with community resources, agencies, and advocacy groups</li>
<li>Program Coordination &amp; Reporting</li>
<li>Manage referrals for patients seen in the Memory Disorders Clinic and Neuromuscular program within the</li>
<li>Movement Disorders and Neurorestoration program</li>
<li>Monitor and respond to notifications from the Silver Alert Listserv in accordance with established guidelines</li>
<li>Conduct annual service provider and caregiver trainings related to memory care</li>
<li>Participate in Elder Affairs trainings and Memory Disorders quarterly meetings</li>
<li>Attend required clinics at FIND and support program initiatives</li>
<li>Track and report on specialized training programs developed or delivered</li>
<li>Submit required quarterly and annual reports for Elder Affairs</li>
<li>Maintain and log patient data in tracking systems for FIND</li>
</ul>
<p>Crisis Intervention &amp; Documentation</p>
<ul>
<li>Respond promptly to urgent patient and family needs, providing appropriate crisis intervention</li>
<li>Effectively manage high-pressure situations and problem-solve with limited information</li>
<li>Communicate critical issues to appropriate stakeholders in a timely manner</li>
<li>Identify priorities within complex situations and implement solutions efficiently</li>
<li>Document services in the electronic medical record (EMR) and maintain accurate records</li>
</ul>
<p>Professional Engagement &amp; Representation</p>
<ul>
<li>Attend required meetings, conferences, and trainings</li>
<li>Participate in committees and focus groups</li>
<li>Represent FIND at internal and external meetings and events</li>
<li>Complete all required reports and assignments within established timelines</li>
</ul>
<p>Cross-Coverage Support</p>
<ul>
<li>Provide backup support for case coordination across other divisions as needed</li><br>
</ul>
<p><b>We Offer Exceptional Benefits</b></p>
<p><b>
Low-cost State Health Plans:</b> Medical, Dental, and Vision Insurance<br>
<b>Life and Disability Insurance</b><br>
<b>Generous Retirement Options</b> to secure your future<br>
<b>Comprehensive Paid Time Off Packages:</b> (includes over 10 paid holidays, as well as paid family, sick and vacation leave)<br>
<b>Exceptional Personal and Professional Development Opportunities:</b> Access to UF Training &amp; Organizational Development programs, leadership development, LinkedIn Learning, and more<br>
<b>Tuition Assistance</b> through the UF Employee Education Program<br>
<b>Public Service Loan Forgiveness</b> (PSLF) Eligible Employer</p><br>
<p></p>
<p><b>
About Gainesville, Florida</b></p>
<p>
Home to the University of Florida, one of the nation's top public universities, Gainesville offers vibrant academic and healthcare communities alongside an affordable cost of living, no state income tax, and mild winters. Enjoy the outdoors with over 30 miles of bike trails, freshwater springs, and numerous water activities, plus easy access to beaches and world-class theme parks.</p>
<p>
Gainesville combines historic charm with modern amenities, including a great school system, a lively downtown, and a thriving local culture with farmers' markets and craft breweries. Discover professional growth and quality of life in Gainesville&mdash;where community, innovation, and work-life balance meet!</p>
<p>
For more information, check out: The Guide to Greater Gainesville and Explore Gainesville in 60 seconds</p></div><br>
</div><br>
<div><div><b>EXPECTED SALARY:</b></div>
<div>
<p>$55,000 - $60,000 annually</p></div><br>
</div><br>
<div><div><b>MINIMUM QUALIFICATIONS:</b></div>
<div>
<p>Master's degree in an appropriate area; or a bachelor's degree in an appropriate area and two years of relevant experience.</p></div><br>
</div><br>
<div><div><b>PREFERRED QUALIFICATIONS:</b></div>
<div>
<p>The ideal candidate must possess:</p>
<ul>
<li>Bachelor&rsquo;s degree in social work or a related field with one-year previous social service or casework
<br>
experience or appropriate college practicum.</li>
<li>Knowledge of the professional principles and skills used in the practice of social work</li>
<li>Professional empathy in dealing with families</li>
<li>Sense of professional identity while collaborating with co-workers</li>
<li>Awareness of community resources and programs for the disabled and elderly</li>
<li>Appropriate professional judgment, courtesy and tact.</li>
</ul>
</div></div><br>
<div><div><b>SPECIAL INSTRUCTIONS TO APPLICANTS:</b></div>
<div>
<p><b>To be considered, please upload the following:</b></p>
<ul>
<li>Cover Letter</li>
<li>Resume</li>
<li>Contact information for three professional references</li>
</ul>
<p>Application must be submitted by 11:55 p.m. (ET) of the posting end date.</p></div><br>
</div><br>
<div><div><b>HEALTH ASSESSMENT REQUIRED:</b></div> <div>Yes</div></div></div><br>
</div>
</div><p></p><div><p><b>ADVERTISED:</b></p>
<div>10 Apr 2026</div> Eastern Daylight Time<br>
<p><b>APPLICATIONS CLOSE:</b></p>
<div><div>24 Apr 2026</div></div>
Eastern Daylight Time</div></div><p></p>

Clinical Case Manager I- Neurology- Movement Disorders Division

Houston Methodist

<div>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 and achievement of desired treatment outcomes. The CM PRN holds joint accountability with social worker for discharge planning and continuity of care and assures that admission and continued stay are medically necessary and communicates clinical information to payors to ensure reimbursement. The CM PRN helps drive change by identifying areas where performance improvement is needed (e.g., day-to-day workflow, education, process improvements, patient satisfaction).
<div><b>FLSA STATUS</b><br>
Non-exempt<br>
<br>
<b>QUALIFICATIONS</b><br>
<br>
<b>EDUCATION</b><ul><li>
Graduate of education program approved by the credentialing body for the required credential(s) indicated below in the Certificates, Licenses and Registrations section.
</li></ul><br>
<b>EXPERIENCE</b><ul><li>
Three (3) years hospital clinical nursing experience which includes two (2) years in case management
</li></ul><br>
<b>LICENSES AND CERTIFICATIONS</b><br>
<b>Required</b><ul><li>
RN - Registered Nurse - Texas State Licensure - Texas Board of Nursing_PSV Compact Licensure &ndash; Must obtain permanent Texas license within 60 days (if establishing Texas residency)
</li></ul><br>
<b>SKILLS AND ABILITIES</b><ul><li>
Demonstrates the skills and competencies necessary to safely perform the assigned job, determined through on-going skills, competency assessments, and performance evaluations.
</li><li>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.
</li><li>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.
</li><li>Strong assessment, organizational and problem-solving skill as evidenced by capacity to prioritize multiple tasks and role components
</li><li>Knowledge of Medicare, Medicaid and Managed Care requirements
</li><li>Comprehensive knowledge of community resources, health care financial and payer requirements/issues, and eligibility for state, local and federal programs
</li><li>Comprehensive knowledge of discharge planning, utilization management, case management, performance improvement and managed care reimbursement.
</li><li>Understanding of pre-acute and post-acute venues of care and post-acute community resources.
</li><li>Ability to work independently
</li><li>Strong assessment, organizational and problem-solving skill as evidenced by capacity to prioritize multiple tasks and role components
</li><li>Demonstrates critical thinking and makes decisions using evidence-based analytical approach in interactions with physicians, payors, and patients and their families
</li>Well versed in computer skills of the entire Microsoft Office Suite (Access, Excel, Outlook, PowerPoint and Word)<br>
<li>
</li></ul><br>
<br>
<b>ESSENTIAL FUNCTIONS</b><br>
<br>
<b>PEOPLE ESSENTIAL FUNCTIONS</b><ul><li>
Collaborates with the physician and all members of the interprofessional health care team to facilitate care for designated case load; monitors the patient&rsquo;s progress, intervening as needed to ensure that the plan of care and services provided are patient-focused, high quality, efficient, and cost-effective; facilitates timely: &bull; completion and reporting of diagnostic testing; &bull; completion of treatment plan and discharge plan; &bull; modification of plan of care, as necessary, to meet the ongoing needs of the patient; &bull; assignment of appropriate levels of care; &bull; completion of all required documentation in EPIC and MIDAS
</li><li>Serves as a preceptor, as appropriate, and implements staff education specific to patient populations and unit processes; coaches and mentors other staff and students. Serves a resource for case management and social work resources and needs for the department and the hospital.
</li></ul><br>
<b>SERVICE ESSENTIAL FUNCTIONS</b><ul><li>
Performs review for medical necessity of admission, continued stay and resource use, appropriate level of care and program compliance. Identifies when services no longer meet InterQual/Millman l criteria, initiates discussion with attending physicians, coordinates with the external case manager to facilitate discharge planning, seeks assistance from the physician advisor, if needed, and informs management of the possible need for issuing Medicare Hospital Initiated Notice of Non-coverage.
</li><li>Applies approved utilization criteria to monitor appropriateness of admissions, level of care, resource utilization, and continued stay. Reviews level of care denials to identify trends and collaborate with team to recommend opportunities for process improvement.
</li></ul><br>
<b>QUALITY/SAFETY ESSENTIAL FUNCTIONS</b><ul><li>
Documents assessment and interventions efficiently and effectively.
</li><li>Plans for routine/difficult discharge and anticipates/prevents and manages emergent situations. Specific focus given to discharge plan and elimination of barriers.
</li><li>Performs post-discharge review by analyzing the inpatient record to ensure that compliance with quality indicators are met. Intervenes and takes appropriate action to foster real-time compliance with CMS guidelines and other performance measures associated with certification programs and other regulatory, national, regional or locally- sponsored quality programs. Provides reports, as needed, to appropriate parties showing: &bull; compliance with established governmental and/or institutional rules and regulations &bull; analysis of problematic areas, and &bull; actions taken to improve compliance
</li><li>Conducts chart audits and performs peer-to-peer evaluations for continuous quality improvement.
</li><li>Identifies opportunities to improve patient satisfaction with focus on discharge domain and collaborates with unit leadership to implement evidence-based patient engagement strategies.
</li></ul><br>
<b>FINANCE ESSENTIAL FUNCTIONS</b><ul><li>
Monitors Length of Stay (LOS) for case load on an ongoing basis. Identifies population and/or service-specific trends impacting LOS and addresses/resolves problems impeding treatment progress. Proactively takes action to achieve continuous improvement and expedite care/facilitate discharge. Contributes to meeting departmental financial target on scorecard
</li><li>Manages all patients in Observation Status, daily, informing physicians of timely disposition options to assure maximum benefits for patients and reimbursement for the hospital.
</li><li>Secures reimbursement for hospital services by communicating medical information required by all external review entities, managed care contracts, insurers, fiscal intermediaries, and state and federal agencies. Responds to requests for information, monitors covered days, and initiates review to assure that all days are covered and reimbursable.
</li></ul><br>
<b>GROWTH/INNOVATION ESSENTIAL FUNCTIONS</b><ul><li>
Provides education to unit-based physicians, nurses, and other healthcare providers on any case management topics.
</li><li>Identifies opportunity for practice changes. Offers innovative solutions through evidence-based practice/performance improvement projects and shared governance activities.
</li>Identifies and presents areas for innovation, efficiency and improvement in case management or department operations using evidence-based practice literature. Completes and updates the individual development plan (IDP) on an on-going basis.<br>
<li>
</li></ul><br>
<br>
<b>SUPPLEMENTAL REQUIREMENTS</b><br>
<ul><b>
WORK ATTIRE</b><li><ul><li>
Uniform: No
</li><li>Scrubs: No
</li><li>Business professional: Yes
</li><li>Other (department approved): No
</li></ul></li><br>
<b>ON-CALL*</b><br>
<li><ul><li><i>Note that employees may be required to be on-call during emergencies (ie. Disaster, Severe Weather Events, etc) regardless of selection below.</i></li></ul></li><li><ul><li>
On Call* Yes
</li></ul></li><br>
<b>TRAVEL**</b><br>
<i>**Travel specifications may vary by department**</i><li><ul><li>
May require travel within the Houston Metropolitan area Yes
</li><li>May require travel outside Houston Metropolitan area No
</li></ul></li></ul></div><b>QUALIFICATIONS</b><br>
<br>
<b>EDUCATION</b><ul><li>
Graduate of education program approved by the credentialing body for the required credential(s) indicated below in the Certificates, Licenses and Registrations section.
</li></ul><br>
<b>EXPERIENCE</b><ul><li>
Three (3) years hospital clinical nursing experience which includes two (2) years in case management
</li></ul><br>
<b>LICENSES AND CERTIFICATIONS</b><br>
<b>Required</b>
RN - Registered Nurse - Texas State Licensure - Texas Board of Nursing_PSV Compact Licensure &ndash; Must obtain permanent Texas license within 60 days (if establishing Texas residency)<br>
<ul><li>
</li></ul><br>
<p><b>Company Profile:</b></p><p>
Houston Methodist Sugar Land Hospital is committed to leading medicine by delivering the Houston Methodist standard of unparalleled quality, safety, service and innovation to patients in Fort Bend County and surrounding areas. Houston Methodist Sugar Land offers access to the most innovative care available, including comprehensive cancer care; neuroscience and spine care; orthopedics and sports medicine; heart and vascular care; women&rsquo;s services; childbirth center with level III NICU; bariatric and digestive care; and advanced imaging &mdash; all backed by our focus on healing people today and offering hope for tomorrow.</p><p>
Houston Methodist is an Equal Opportunity Employer.</p></div>

Case Manager PRN

Ernest Health

<div>Overview:
<div><b>
Case Manager - Per Diem-New Braunfels Regional Rehabilitation Hospital</b></div><div></div><div><b><br>
New Braunfels Regional Rehabilitation Hospital</b> in New Braunfels, Texas is a leading inpatient rehabilitation hospital serving the communities between San Antonio and Austin. We specialize in helping patients regain strength and independence after life-altering health events such as strokes, brain or spinal cord injuries, complex orthopedic surgeries, and other serious conditios.</div><div><br>
</div><div>Our rehabilitation programs are intensive and tailored &ndash; each patient receives a customized mix of physical, occupational, and speech therapies delivered daily by our enthusiastic, highly skilled team. New Braunfels Regional Rehab Hospital offers a supportive, close-knit environment with modern therapy facilities and the latest rehabilitative equipment, ensuring patients get the best possible care.</div><div><br>
</div><div>With Joint Commission accreditation and a reputation for outstanding clinical outcomes, our hospital proudly provides warm, patient-centered care that guides individuals on their journey to recovery and return to an active life.</div><div></div><div><b><br>
We are seeking a PRN Case Manager to join our team of passionate patient caregivers!</b></div><div></div><div><i><br>
As a participating hospital of Ernest Health, we offer robust recognition, wellness, and retention programs. These programs focus to enhance the employees&rsquo; work experience, recognize, and celebrate achievements. We also encourage employees to share their work experience through &ldquo;My Ernest Journey&rdquo; and through our Engagement Survey, where our approach is &ldquo;You Spoke, We Listened&rdquo;. These platforms provide additional avenues for employees to give feedback about their work experience and share what is important to them.</i></div><div><br>
</div>Qualifications:
<div><b>
Required Skills:</b></div><ul><li>
Current clinical licensure strongly preferred.</li><li>
One year recent relevant experience required. Acute care setting preferred.</li></ul><div></div><div><b><br>
Additional Qualifications/Skills:</b></div><ul><li>
Demonstrates an understanding of treatment costs and financial support as they relate to quality and efficiency.</li><li>
Demonstrates critical thinking skills: Using logic and reasoning to identify the strengths and weaknesses of alternative solutions, conclusions or approaches to problems.</li><li>
Utilizes the appropriate leadership skills in delegating, organizing, and educating coworkers and staff.</li><li>
Knowledge of community resources to meet post-discharge clinical and social needs.</li><li>
Knowledge of clinical operations and procedures.</li><li>
Ability to establish and maintain pro-active relationships with internal interdisciplinary team members, local payer, physicians, community service organizations and health care facilities.</li><li>
Ability to maintain quality, safety, and/or infection control standards.</li><li>
Demonstrates general computer skills including: data entry, word processing, email, and record management.</li><li>
Effective organizational and time management skills.</li><li>
Effective written and verbal communication skills.</li><li>
Ability to maintain proper levels of confidentiality.</li><li>
Ability to work closely and professionally with others.</li></ul><br>
<div></div>
Responsibilities:
<div>
Works with physicians and multidisciplinary team members to develop a plan of care for assigned patients. Ensures patient is progressing towards desired outcomes by monitoring care through assessments and/or patient records. Identifies and resolves barriers that hinder effective patient care. Actively involved in discharge planning process. Integrates the hospital&rsquo;s mission and &ldquo;Guiding Principles&rdquo; into daily practice.</div></div>

Case Manager - Per Diem

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