Case Manager - The Woodlands, United States - Memorial Hermann Health System

Memorial Hermann Health System

Verified Company

The Woodlands, United States

2 weeks ago

Posted by:

Mark Lane

beBee recruiter

Description

At Memorial Hermann, we pursue a common goal of delivering high quality, efficient care while creating exceptional experiences for every member of our community.

When we say every member of our community, that includes our employees.

We know that when our employees feel cared for, heard and valued, they are inspired to create moments that exceed expectations, while prioritizing safety, compassion, personalization and efficiency.

If you want to advance your career and contribute to our vision of creating healthier communities, now and for generations to come, we want you to be a part of our team.

Job Summary

This is for the OBS CM position which is Monday through Friday 8:30 am to 5 pm with back up call for the weekend (3 days in a 3-month period) covering only when the weekend staff is out on PTO or calls in sick.

This position covers 12 patients on 1 unit in the South Tower and 6 patients on another unit in the West Tower.

The purpose of the Case Manager position is to support the physician, primary medical homes, and interdisciplinary teams.

Facilitates patient care, with the underlying objective of enhancing the quality of clinical outcomes and patient satisfaction while managing the cost of care and providing timely and accurate information to payors.

The role integrates and coordinates resource utilization management, care facilitation and discharge planning functions.

In addition, the Case Manager helps drive change by identifying areas where performance improvement is needed (e.g., day to day workflow, education, process improvements, patient satisfaction).

The position is responsible for coordinating a wide range of self management support and provides information to update and maintain relevant disease registry activity.

Accountable for a designated patient caseload and plans effectively in order to meet patient needs across the continuum, provide family support, manage the length of stay, and promote efficient utilization of resources.

Minimum Qualifications

Education:
Graduate of an accredited school of professional nursing required; Bachelors of Nursing preferred, or graduate of an accredited Master of Social Work program

Licenses/Certifications**:

Current and valid license to practice as a Registered Nurse in the state of Texas or
Current and valid license as a Master Social Worker (LMSW) in the state of Texas required, LCSW preferred
Certification in Case Management required within two (2) years of hire into the Case Manager position

Experience / Knowledge / Skills:

Three (3) years of nursing or social work experience acute hospitalbased preferred, or three (3) years of experience comparable clinical setting (i.e. ambulatory surgery center, infusion/dialysis clinic, Federally Qualified Health Clinic (FQHC), skilled nursing facility, or wound clinic).
Experience in utilization management, case management, discharge planning or other cost/quality management program preferred
Excellent interpersonal communication and negotiation skills
Demonstrated leadership skills
Strong analytical, data management and PC skills
Current working knowledge of discharge planning, utilization management, case management, performance improvement, disease or population management and managed care reimbursement
Understanding of preacute and postacute venues of care and postacute community resources, physician office routines, and transitional procedures for pre and post acute care. Demonstrated understanding of motivational interviewing and change management.
Strong organizational and time management skills, as evidenced by capacity to prioritize multiple tasks and role components
Ability to work independently and exercise sound judgment in interactions with physicians, payors, and patients and their families
Effective oral and written communication skills

Principal Accountabilities

Coordinates/facilitates patient care progression throughout the continuum.
Works collaboratively and maintains active communication with physicians, nursing and other members of the multidisciplinary care team to effect timely, appropriate patient care.
Addresses/resolves system problems impeding diagnostic or treatment progress.
Proactively identifies and resolves delays and obstacles to discharge.
Seeks consultation from appropriate disciplines/departments as required to expedite care and facilitate discharge.
Utilizes advanced conflict resolution skills as necessary to ensure timely resolution of issues.
Collaborates with the physician and all members of the multidisciplinary team to facilitate care for designated case load. Monitors the patient's progress, intervening as necessary and appropriate to ensure that the plan of care and services provided are patient focused, high quality, efficient, and cost effective.
Facilitates the following on a timely basis: Completes and reports diagnostic testing, Completes treatment plan and discharge plan, Modifies pla