Staff Position

Registered Nurse (RN) - Case Management
Memorial Hermann - Texas Medical Center
Houston, TX
3x12 hrs, Days, Nights

$45+/hour

Overview

Start DateASAP
Shift Breakdown3x12 hrs
ShiftDays, Nights
Facility Information
Short Term Acute Care1089 bedsOracle Cerner

Pay

5% higher than average Registered Nurse / Nurse Case Manager pay in Texas

Estimated pay

$45+/hour

Benefits

Dental benefits
Vision benefits
Employee assistance programs
403b retirement plan
Health Care FSA
Dependent Care FSA
School loan reimbursement

Qualifications

The employer will review your Vivian profile and compare it against the job qualifications listed below.

Required

License

Texas Nursing License

Other

Eligible to work in US

Other qualifications

Other

Compact licensure accepted

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

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.Job Description

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 hospital-based 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 pre-acute and post-acute venues of care and post-acute 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 multi-disciplinary 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 plan of care as necessary, to meet the ongoing needs of the patient, Communicates to third party payors and other relevant information to the care team.
Assigns appropriate levels of care.
Completes all required documentation in TQ screens and patient records
Collaborates with medical staff, nursing staff, and ancillary staff to eliminate barriers to efficient delivery of care in the appropriate setting.
Completes Utilization Management and Quality Screening for assigned patients.
Applies approved clinical appropriateness criteria to monitor appropriateness of admissions and continued stays, and documents findings based on Department standards.
Identifies at-risk populations using approved screening tool and follows established reporting procedures. Monitors LOS and ancillary resource use on an ongoing basis.
Takes actions to achieve continuous improvement in both areas.
Refers cases and issues to Care Management Medical Director in compliance with Department procedures and follows up as indicated.
Communicates with Resource Center to facilitate covered day reimbursement certification for assigned patients.
Discusses payor criteria and issues on a case-by-case basis with clinical staff and follows up to resolve problems with payors as needed.
Uses quality screens to identify potential issues and forwards information to Clinical Quality Review Department.
Ensures that all elements critical to the plan of care have been communicated to the patient/family and members of the healthcare team and are documented as necessary to assure continuity of care.
Manages all aspects of discharge planning for assigned patients.
Meets directly with patient/family to assess needs and develop an individualized continuing care plan in collaboration with physician.
Collaborates and communicates with multidisciplinary team in all phases of discharge planning process, including initial patient assessment, planning, implementation, interdisciplinary collaboration, teaching and ongoing evaluation.
Ensures/maintains plan consensus from patient/family, physician and payor.
Refers appropriate cases for social work intervention based on Department criteria.
Collaborates/communicates with external case managers.
Initiates and facilitates referrals through the Resource Center for home health care, hospice, medical equipment and supplies.
Documents relevant discharge planning information in the medical record according to Department standards.
Facilitates transfer to other facilities as appropriate.
Actively participates in clinical performance improvement activities.
Assists in the collection and reporting of financial indicators including case mix, LOS, cost per case, excess days, resource utilization, readmission rates, denials and appeals.
Uses data to drive decisions and plan/implement performance improvement strategies related to case management for assigned patients, including fiscal, clinical and patient satisfaction data.
Collects, analyzes and addresses variances from the plan of care/care path with physician and/or other members of the healthcare team.
Uses concurrent variance data to drive practice changes and positively impact outcomes.
Collects delay and other data for specific performance and/or outcome indicators as determined by Director of Outcomes Management. Documents key clinical path variances and outcomes which relate to areas of direct responsibility (e.g., discharge planning).
Uses pathway data in collaboration with other disciplines to ensure effective patient management concurrently.
Leads the development, implementation, evaluation and revision of clinical pathways and other Case management tools as a member of the clinical resource/team.
Assists in compilation of physician profile data regarding LOS, resource utilization, denied days, costs, case mix index, patient satisfaction and quality indicators (e.g., readmission rates, unplanned return to OR, etc.)
Acts as preceptor/mentor to new hires.
Assists in development of orientation schedule and helps identify individual needs for learning.
Ensures safe care to patients, staff and visitors; adheres to all Memorial Hermann policies, procedures, and standards within budgetary specifications including time management, supply management, productivity and quality of service.
Promotes individual professional growth and development by meeting requirements for mandatory/continuing education and skills competency; supports department-based goals which contribute to the success of the organization; serves as preceptor, mentor and resource to less experienced staff.
Demonstrates commitment to caring for every member of our community by creating compassionate and personalized experiences. Models Memorial Hermann's service standards by providing safe, caring, personalized and efficient experiences to patients and colleagues.
Other duties as assigned.

Memorial Hermann Health System Job ID #100160309. Posted job title: case manager

Facility

Memorial Hermann - Texas Medical Center

3.8rating(24 reviews)

1 nurse recommends working with Memorial Hermann - Texas Medical Center

5.0rating

Anonymous

ICU - Intensive Care Unit (RN)

Staff Position

Review of Memorial Hermann - Texas Medical Center on Aug 28, 2024

View all reviews

DetailsVerification data is contributed by healthcare professionals like you, who leave reviews on Vivian.

Short Term Acute Care
1089 beds
Oracle Cerner

ADDRESS6411 Fannin StHouston, TX 77030

View more details

Employer

Memorial Hermann Health System

4.0rating(2 reviews)

Compensation

3.8rating

Culture

4.0rating

Work Environment

3.8rating

3.0rating

Anonymous

Radiology Technician (Allied Health Professional)

Review of Memorial Hermann Health System on Oct 10, 2024

View all reviews

About

Company Overview:Charting a better future. A future that’s built upon the HEALTH of our community. This is the driving force for Memorial Hermann, redefining health care for the individuals and many diverse populations we serve. Our 6,600+ affiliated physicians and 33,000+ employees practice the highest standards of safe, evidence-based, quality care to provide a personalized and outcome-oriented experience across our more than 270 care delivery sites. As one of the largest not-for-profit health systems in Southeast Texas, Memorial Hermann has an award-winning and nationally acclaimed Accountable Care Organization, 17* hospitals and numerous specialty programs and services conveniently located throughout the Greater Houston area. Memorial Hermann-Texas Medical Center is one of the nation's busiest Level I trauma centers and serves as the primary teaching hospital for McGovern Medical School at UTHealth. For more than 114 years, our focus has been the best interest of our community, contributing more than $411 million annually through school-based health centers and other community benefit programs. Now and for generations to come, the health of our community will be at the center of what we do – charting a better future for all.
*Memorial Hermann Health System owns and operates 14 hospitals and has joint ventures with three other hospital facilities, including Memorial Hermann Surgical Hospital First Colony, Memorial Hermann Surgical Hospital Kingwood and Memorial Hermann Rehabilitation Hospital-Katy.
Our MissionMemorial Hermann Health System is a non-profit, values-driven, community-owned health system dedicated to improving health.
Our VisionTo create healthier communities, now and for generations to come.
Our ValuesCommunity: We value diversity and inclusion and commit to being the best healthcare provider, employer and partner.Compassion: We understand our privileged role in people's lives and care for everyone with kindness and respect.Credibility: We conduct ourselves and our business responsibly and prioritize safety, quality and service when making decisions.Courage: We act bravely to innovate and achieve world-class experience and outcomes for patients, consumers, partners and the community.

Response timemore than a day

Staff jobs$23–71/hour

Local contracts$23–71/hour

Per Diem / PRN roles$23–71/hour

Jobs on Vivian132

View more details

About Houston, TX

Cost of Living

Houston's cost of living is slightly below the national average, making it an affordable place to live.
Wages generally match up with the lower cost of living.

Weather

Summer highs average around 90°F (32°C) with lows around 75°F (24°C), while winter highs average around 63°F (17°C) with lows around 45°F (7°C).

Furnished Housing

Short term rentals are readily available in Houston, with a variety of options to choose from.

Transportation

Houston is car-friendly with a well-developed highway system.
Public transportation is available through the METRO bus and light rail services.

Demographics

Houston is a diverse city with a wide range of ethnicities and age groups.
Common health issues include allergies, asthma, and obesity.
There is a large population of travel nurses due to the numerous healthcare facilities in the area.

Things to Do

Houston offers a vibrant culinary scene with diverse restaurants, a thriving art and music community, professional sports teams, and plenty of outdoor activities including parks and nearby coastal attractions.

Was this helpful?

Yes

We strive to have reliable information about every job. Tell us what we've got wrong so we can correct it.Report an issue