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