Job Description

Job Description

Job Description

Are you a BSN RN with recent acute care case management hospital experience ?

or

Are you a Licenced Master Social Worker (LMSW) or Licensed Clinical Social Worker (LCSW) certified in case management or with a desire to be certified?

If so, I have the perfect role for you!

Keep reading...

I am working with a Houston, Texas hospital that seeks a knowledgeable Acute Care Case Manager with hospital experience , to support the physician, primary medical homes, and interdisciplinary teams.

This is a great opportunity where you'll be empowered to do what's best for patients, advance in your career, work independently , and demonstrate leadership and strong analytical, organizational, and time management skills.

The goal of this position – your core purpose and duty - is to support the physician, primary medical homes, and interdisciplinary teams. Facilitate patient care, plan effectively to meet patient needs across the continuum, and promote efficient utilization of resources to enhance the quality of clinical outcomes and patient satisfaction.

Your role daily…

• You will coordinate/facilitate and monitor patient care progression, working collaboratively and actively communicating with physicians, nurses, and other members of the multidisciplinary care team to effect timely, appropriate patient care

• You will proactively identify and resolve delays and obstacles to discharge

• You will complete and report diagnostic testing, complete and modify treatment plans and discharge plans of care as necessary, to meet the ongoing needs of the patient.

• You will refer cases and issues to the Care Management Medical Director in compliance with department procedures and follow up

• You will discuss payor criteria and issues on a case-by-case basis with clinical staff and follow up to resolve problems with payors as needed

• You will meet with patients and their families to assess their needs and develop an individualized continuing care plan in collaboration with the physician.

• You will assist in collecting and reporting financial indicators including case mix, LOS, cost per case, excess days, resource utilization, readmission rates, denials, and appeals.

• You will use data to drive decisions and plan/implement performance improvement strategies related to case management for assigned patients, including fiscal, clinical, and patient satisfaction data.

• You will collect, analyzes, and address variances in the plan of care/care path, with physicians, and other members of the care team.

• You will lead the development, implementation, evaluation and revision of clinical pathways and other case management tools.

• You will act as preceptor/mentor to new hires and less experienced staff

Sounds Exciting?! YES! Great! So, if you're interested, let me tell you what you will need to qualify for this rol e:

Education :

• Graduated from an accredited school of professional nursing; Bachelor of Nursing preferred

• Or Graduate of an accredited Master of Social Work program

• Current and valid licensed Registered Nurse in Texas

• Or valid license as a Master Social Worker (LMSW) in The State of Texas

• Or LCSW (preferred)

Skills:

• 3 years of nursing or social work experience in an acute hospital setting

• Recent acute care case management hospital experience

• Or 3 years of comparable clinical experience (i.e. ambulatory surgery center, infusion/dialysis clinic, Federally Qualified Health Clinic (FQHC), skilled nursing facility, or wound clinic)

• Demonstrated leadership skills, effective oral and written communication, organizational and time management skills

• Strong analytical, data management, and PC skills.

• Experience in utilization management, case management, discharge planning, or other cost/quality management programs preferred.

• Current knowledge of discharge planning, utilization management, case management, performance improvement, disease or population management, and managed care reimbursement.

• An 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.

• Ability to work independently and exercise sound judgment in interactions with physicians, payors, patients, and their families.

If this role excites you and describes your career goals, please apply now! I would love to help you reach your goal!

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