Case Management Processor Jobs in Houston, TX (NOW HIRING)

Education: Bachelor's of Science in Nursing OR Social Work (BSW). Master’s degree preferred*

*Note: effective March 1, 2019 and going forward, these are the minimum qualifications for this role; incumbents hired before March 1, 2019 may have commensurate experience in lieu of BSN.

Licenses/Certifications:

• Current and valid license to practice as a Registered Nurse in the state of Texas or

• Licensed Master Social Worker (LMSW) required, LCSW preferred

• Case Manager Certification required

Experience/ Knowledge/ Skills:

• Minimum five (5) years experience in utilization management, case management, discharge planning or other cost/quality management program

• Three (3) years of experience in hospital-based nursing or social work

• Three (3) years of demonstrated leadership experience

• Knowledge of leading practice in clinical care and payor requirements

• Self-motivated, proven communication skills, assertive

• Background in business planning, and targeted outcomes

• Working knowledge of managed care, inpatient, outpatient, and the home health continuum, as well as utilization management and case management

• Working knowledge of the concepts associated with Performance Improvement

• Demonstrated effective working relationship with physicians

• Ability to work collaboratively with health care professionals at all levels to achieve established goals and improve quality outcomes

• Effective oral and written communication skills

Principal Accountabilities

• Assists in supervising and managing all aspects of the local level program.

• Supports growth and development of the case management program consistent with enterprise wide philosophy and in response to the dynamic nature of the health care environment through benchmarking for best practices, networking, quality management, and other activities as needed.

• Responsible for coordinating day to day operations of the program at the unit level.

• Assists in identifying and achieving optimal targeted financial outcomes via the inpatient case management process.

• Participates in departmental personnel functions (hiring, firing, etc.) in conjunction with the Director of Case Management.

• Provides input to annual and interim performance appraisal reviews for the professional and non-professional staff in department.

• Acts as liaison to facilitate communication and collaboration between all care partners (physicians, hospitalists, community care managers, nurses, community resources, etc.)

• Responsible for leading a high performance team of “system thinkers” who incorporate leadership principles and vision in performing the functions of case management.

• Uses data to drive decisions, plan, and implement performance improvement strategies for case management.

• 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.