Case Manager

Essential Responsibilities

• Captures and coordinates patient care through assessment, evaluation, planning, and implementation.
• Serves as the primary case management contact for other departments within the district.
• Oversees and assists all members of the case management team.
• Collaborates with executive leadership to address departmental issues and concerns.
• Consults with healthcare teams to identify patients' needs and treatment options.
• Determines patients' eligibility for services through multidisciplinary team members.
• Works with physicians to refer services available within the hospital district.
• Communicates with patients and families regarding their plan of care after services.
• Maintains records and monitors the necessity of services within the district.
• Reviews patient records to compile utilization review information.
• Maintains accurate and timely records for submission to the business office to facilitate billing flow.
• Prepares and presents educational sessions and materials for medical staff and outpatient clinic staff.

Patient Advocate Duties

• Identifies the need for additional services for patients.
• Builds a network of federal, state, and community resources.
• Maintains records for all assistance programs used and people helped through these services.
• Maintains confidentiality while handling confidential matters.
• Interacts with patients, family members, medical staff, and other department managers.
• Conducts patient satisfaction surveys as required.
• Fulfills safety guidelines and infection control policies for the Hospital District.

Job Qualifications

• Education: High school graduate or equivalent. Associate's degree in nursing preferred. Bachelor's degree preferred.
• Skills: Reading and verbal skills necessary to understand medical records and procedures, effective communication with patients and other staff. Knowledge of Medicare, Medicaid, and welfare programs preferred.
• Licenses, Registrations, Certifications: Registered Nursing License with availability to work in the state of Texas.
• Experience: One year experience as a clinical case manager preferred. Prior experience in quality assurance or utilization review activities preferred.

Physical and Mental Requirements

• This position requires moderate periods of standing and walking.