Registered Nurse Case Manager

Job Summary and Qualifications

Provides overall coordination in the delivery of medical services and discharge planning for a specified patient population. Performs concurrent and retrospective review of patient medical records for purposes of utilization review, compliance with requirements of external review agencies including governmental and non-governmental payers and quality assurance agencies. Promotes a cooperative and supportive relationship as liaison with patient, family, facility staff, physicians, funding representatives and community agencies. Ensures continuity in the handoff of patient clinical information from the hospital to other involved healthcare entities. The duties of the acute care Case Manager may be performed as in the integrated or triad model.

Responsibilities

• Guiding patients and families through program orientation, explaining the rehabilitation philosophy, Medicare and insurance benefits, discharge criteria, and patient rights
• Coordinating education for patients, families, and caregivers to encourage participation in treatment planning, goal discussions, and family conferences
• Developing and implementing individualized treatment plans that reflect the patient’s strengths, needs, and personal recovery goals
• Completing psychosocial assessments and discharge planning evaluations, clearly documenting findings and communicating needs across the care team
• Collaborating closely with the Rehab Program Director, Facility Case Management Director, and interdisciplinary team to ensure seamless, patient-centered care
• Promoting HCA Healthcare’s values of compassion, respect, and excellence through every patient and family interaction

Qualifications

• Required licensure/certifications: RN licensure in the state of TX or Compact State.
• Required education/experience: Associates Degree or BSN.
• Preferred education, licensure, certification, experience, skills, knowledge and abilities:
  • Prefer three‑five years clinical experience within an acute health care setting with recent work history in acute care case management role or related health care experience. Working knowledge of case management philosophy/process/role, needs assessment, principles of utilization review/quality assurance, use of InterQual or other clinical decision support criteria, discharge planning, and reimbursement structures (e.g. Government and non‑governmental payers).
  • Ability to read, analyze and comprehend complex clinical and financial data and its application to level of care criteria and discharge options; strong, broad‑based clinical knowledge and understanding of pathology/physiology of disease processes; excellent critical thinking skills; assertive personality traits to facilitate ongoing physician communication; organize, prioritize and manage time efficiently. Computer literacy and familiarity with the operation of basic office equipment. Must be able to communicate effectively with a wide range of hospital personnel, physicians, patients/family members within various socioeconomic groups and representatives of varied outside agencies. Ability to communicate effectively with and know the age‑specific needs of patients of adolescent, adult and geriatric age.
  • Demonstrate an understanding of HCA’s “Patients First” safety initiative through strict compliance to all safety protocols and procedures.
  • Recognizes that variables such as age, race, nationality, culture, disease‑causing vulnerabilities, and socio‑economic factors affect the patient populations under their care. Uses interventions appropriate to these factors (e.g. interpreter, dietary preferences, social service consult, etc.)

Benefits

• Comprehensive benefits for medical, prescription drug, dental, vision, behavioral health and telemedicine services
• Wellbeing support, including free counseling and referral services
• Time away from work programs for paid time off, paid family leave, long‑ and short‑term disability coverage and leaves of absence
• Savings and retirement resources, including a 401(k) Plan with a 100% match on 3% to 9% of pay (based on years of service), Employee Stock Purchase Plan, flexible spending accounts, preferred banking partnerships, retirement readiness tools, rollover support and financial wellbeing counseling
• Education support through tuition assistance, student loan assistance, certification support, dependent scholarships and a partnership with Galen College of Nursing
• Additional benefits for fertility and family building, adoption assistance, life insurance, supplemental health protection plans, auto and home insurance, legal counseling, identity theft protection and consumer discounts

Eligibility for benefits may vary by location.

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.