Case Manager-Registered Nurse (RN)-PRN

About the role

The Case Manager-Registered Nurse (RN) position is available on a PRN basis at Houston Methodist Hospital. This role requires a graduate of an approved education program and three years of hospital clinical nursing experience, including two years in case management. The position involves collaborating with the interprofessional health care team, facilitating care plans, and ensuring timely completion of diagnostic tests, treatment plans, and discharge plans.

Responsibilities

• Collaborates with the physician and health care team to facilitate care for designated case load
• Makes timely completion of diagnostic tests, treatment plans, and discharge plans
• Facilitates modification of the plan of care as necessary to meet patient needs
• Assigns appropriate levels of care and ensures all required documentation is completed in EPIC and MIDAS
• Serves as a preceptor and implements staff education specific to patient populations and unit processes
• Coordinates discharge planning and identifies when services no longer meet InterQual/Millman criteria
• Documents assessment and interventions efficiently and effectively
• Plans for routine and difficult discharges, anticipates and manages emergent situations, and intervenes to foster compliance with CMS guidelines
• Performs post-discharge reviews, conducts chart audits, and performs peer-to-peer evaluations for continuous quality improvement
• Monitors Length of Stay (LOS) for case load, identifies trends, and addresses problems impeding treatment progress
• Manages patients in Observation Status, informs physicians of timely disposition options, and secures reimbursement for hospital services
• Provides education to unit-based physicians, nurses, and other healthcare providers on case management topics
• Identifies and presents areas for innovation, efficiency, and improvement in case management or department operations
• Ensures compliance with governmental and institutional rules and regulations

Requirements

• Graduate of an approved education program
• Three years of hospital clinical nursing experience, including two years in case management
• RN - Registered Nurse - Texas State Licensure - Texas Board of Nursing_PSV Compact Licensure – Must obtain permanent Texas license within 60 days (if establishing Texas residency)
• Strong assessment, organizational, and problem-solving skills
• Knowledge of Medicare, Medicaid, and Managed Care requirements
• Comprehensive knowledge of community resources, health care financial and payer requirements/issues, and eligibility for state, local, and federal programs
• Comprehensive knowledge of discharge planning, utilization management, case management, performance improvement, and managed care reimbursement
• Understanding of pre-acute and post-acute venues of care and post-acute community resources
• Ability to work independently
• Strong assessment, organizational, and problem-solving skills as evidenced by capacity to prioritize multiple tasks and role components
• Demonstrates critical thinking and makes decisions using evidence-based analytical approach in interactions with physicians, payors, and patients and their families
• Well versed in computer skills of the entire Microsoft Office Suite (Access, Excel, Outlook, PowerPoint and Word)

Skills and Abilities

• Demonstrates the skills and competencies necessary to safely perform the assigned job, determined through on-going skills, competency assessments, and performance evaluations
• Sufficient proficiency in speaking, reading, and writing the English language necessary to perform the essential functions of this job, especially with regard to activities impacting patient or employee safety or security
• Ability to effectively communicate with patients, physicians, family members and co-workers in a manner consistent with a customer service focus and application of positive language principles
• Knowledge of Medicare, Medicaid and Managed Care requirements
• Comprehensive knowledge of community resources, health care financial and payer requirements/issues, and eligibility for state, local and federal programs
• Comprehensive knowledge of discharge planning, utilization management, case management, performance improvement and managed care reimbursement
• Understanding of pre-acute and post-acute venues of care and post-acute community resources
• Ability to work independently
• Strong assessment, organizational and problem-solving skill as evidenced by capacity to prioritize multiple tasks and role components
• Demonstrates critical thinking and makes decisions using evidence-based analytical approach in interactions with physicians, payors, and patients and their families
• Well versed in computer skills of the entire Microsoft Office Suite (Access, Excel, Outlook, PowerPoint and Word)

Benefits

Details about benefits will be provided upon employment.

Pay

Details about pay will be provided upon employment.

Schedule

Details about schedule will be provided upon employment.

Company Profile

Houston Methodist Hospital is recognized by U.S. News & World Report as the No. 1 hospital in Texas and one of America’s “Best Hospitals.” As a full-service, acute-care hospital located in the Texas Medical Center and the flagship hospital of Houston Methodist, it has evolved into one of the nation’s largest nonprofit teaching hospitals and a leader in innovative medical research with a comprehensive residency program. Two of Houston Methodist’s primary academic affiliates are among the nation’s leading health care organizations: Weill Cornell Medicine and New York-Presbyterian Hospital. Houston Methodist also has affiliations with Texas A&M University and the University of Houston. Houston Methodist Hospital offers unparalleled care for thousands of patients from around the world.

Houston Methodist is an Equal Opportunity Employer.