RN Case Management Manager

Full-time RN Case Management Manager needed for a dynamic facility in Houston, Tx. Position offers a competitive salary and robust recruitment package. This is an on-site position.

Job Description Summary

The RN Case Management Manager is responsible and accountable to assist the Director of Case Management in the implementation of the case management program at the local level. The components/roles of the inpatient case management program consist of the following: Care Facilitation, Utilization Management, Case Management and Discharge Planning.

The Manager is responsible for coordinating the use systems and processes for care/utilization management at the hospital level. In addition, the Manager is responsible for to assist the Director in managing the department’s activities related to discharge planning and clinical quality improvement. The Manager coordinates day to day departmental operations and the use of hospital resources appropriately and effectively. The Manager participates in the collection, analysis and reporting of financial and quality data related to utilization management, quality improvement and performance improvement.

Minimum Qualifications

Education: Bachelor's of Science in Nursing OR Social Work (BSW). Master’s degree preferred*

Licenses/Certifications:

Current and valid license to practice as a Registered Nurse in the state of Texas or

Licensed Master Social Worker (LMSW) required, LCSW preferred

Case Manager Certification required

Experience/ Knowledge/ Skills:

Minimum five (5) years' experience in utilization management, case management, discharge planning or other cost/quality management program

Three (3) years of experience in hospital-based nursing or social work

Three (3) years of demonstrated leadership experience

Knowledge of leading practice in clinical care and payor requirements

Self-motivated, proven communication skills, assertive

Background in business planning, and targeted outcomes

Working knowledge of managed care, inpatient, outpatient, and the home health continuum, as well as utilization management and case management

Working knowledge of the concepts associated with Performance Improvement

Demonstrated effective working relationship with physicians

Ability to work collaboratively with health care professionals at all levels to achieve established goals and improve quality outcomes

Effective oral and written communication skills

Principal Accountabilities