Utilization Case Manager Jobs in Dallas, TX (NOW HIRING)

Medical City Dallas

FT Day shift, 8:00am - 4:30pm Monday - Friday with some weekends

As a RN Case Manager, your voice to influence patient care is valued and empowered at every turn –whether through open, collaborative relationships with your direct manager or more formal opportunities through hospital councils and national nursing initiatives. You'll help shape decisions that elevate both patient outcomes and the future of nursing.

Our RN Case Managers raise the bar by providing clinical expertise and the highest quality care in the most compassionate way. The RN Case Manager is responsible for promoting patient-centered care by coordinating the plan of care for the patient stay, managing the length of stay, ensuring appropriate resource management, and developing a safe appropriate discharge plan in collaboration with the multidisciplinary team. The RN Case Manager facilitates the progression and transition of care using established criteria and in conjunction with the multidisciplinary team. The RN Case Manager will coordinate activities that promote quality outcomes and patient throughput while supporting a balance of optimal care and appropriate resource utilization.

What You Will Do In This Role:

• Performs a comprehensive assessment of psychosocial, medical and discharge needs of patients/family along with an assessment of resources appropriate and available to the patient/family
  
• Reassesses the patient’s clinical condition as indicated. Considers patient’s readmission status or risk of readmission and develops strategies to mitigate including education on appropriately accessing healthcare resources, preventative education, and community based resources.
  
• Coordinates the plan of care and drives the discharge plan by collaborating with the multidisciplinary health care team and in particular with the patient's physician to facilitate a successful care transition
  
• In partnership with Social Services, the RN CM is responsible for ensuring the post-acute medical needs and level of care are appropriate
  
• The RN CM is responsible for timely referral to Social Services when risk factors for psychosocial determinants of health are identified
  
• Involves patient, family/responsible/significant others in identifying and clarifying needs and expectations to develop mutual and realistic goals
  
• Evaluates progression of care using evidence-based tools and approved criteria (InterQual) throughout the episode of care; escalates progression and transition of care issues through the established chain of command
  
• Makes appropriate referrals to third party payer, disease and case management programs for recurring patients and patients with chronic disease states
  
• Facilitates patient throughput with an ongoing focus on an effective care transition, quality and efficiency
  
• Documents professional recommendations, discharge plan, care coordination interventions, and case management activities to effectively communicate to all members of the health care team
  
• Align patient’s needs with available resources to ensure a safe discharge / transition
  
• Acts as a liaison through effective and professional communications between and with physicians, patient / family, hospital staff, and outside agencies
  
• Directs activities to identify and provide for the needs of the under-resourced patient population to include patient education activities, patient assistance programs, and community-based resources
• Demonstrates knowledge of regulatory requirements, HCA Ethics and Compliance policies, and quality initiatives
  
• Serve as an advocate for patient's rights, needs, and values; ensuring that patients’ ethnic, cultural, or religious values, beliefs, preferences and needs are considered and aligned
  

What qualifications you will need:

• Registered Nurse with current TX state license required
• Associate Degree in Nursing or Nursing diploma required, Bachelor's Degree in Nursing preferred
• 3+ years of clinical hospital nursing experience required OR 2+ years experience in case management required
• Certification in case management preferred
• InterQual experience preferred

Medical City Dallas, offers a total rewards package that supports the health, life, career and retirement of our colleagues. The available plans and programs include:

• Comprehensive benefits for medical, prescription drug, dental, vision, behavioral health and telemedicine services
• Wellbeing support, including free counseling and referral services
• Time away from work programs for paid time off, paid family leave, long- and short-term disability coverage and leaves of absence
• Savings and retirement resources, including a 401(k) Plan with a 100% match on 3% to 9% of pay (based on years of service), Employee Stock Purchase Plan, flexible spending accounts, preferred banking partnerships, retirement readiness tools, rollover support and financial wellbeing counseling
• Education support through tuition assistance, student loan assistance, certification support, dependent scholarships and a partnership with Galen College of Nursing
• Additional benefits for fertility and family building, adoption assistance, life insurance, supplemental health protection plans, auto and home insurance, legal counseling, identity theft protection and consumer discounts

Learn more about Employee Benefits

Note: Eligibility for benefits may vary by location.

"Nurses are essential to the delivery of healthcare and serve as its foundation. At HCA Healthcare, we are committed to equipping nurses with the tools and resources they need to deliver exceptional patient care, championing the profession, and supporting the advancement of nursing’s future."

Erica Rossitto, MBA/HCM, BSN, RN, NEA-BC
Senior Vice President and Chief Nurse Executive
HCA Healthcare

Medical City Dallas is recognized for its advanced medical facilities and commitment to excellence in patient care. We are an 895+ bed tertiary care center. Our medical team consists of more than 1,500 physicians, many are recognized as the world's best in their specialties. Patients travel to Medical City Dallas from all over the United States and from other countries. We offer sophisticated treatment by our 400+ in-house physician specialists. Medical City Dallas has a full-service adult hospital and pediatric hospital. We have separate adult and pediatric emergency rooms, outpatient clinics and diagnostic centers. Our providers have access to state-of-the-art technology and are pioneering new medical procedures to accommodate patient needs. As a part of the Medical City network of hospitals, patients are ensured access to leading medical experts and advanced healthcare innovations across the network.

HCA Healthcare has been recognized as one of the World's Most Ethical Companies® by the Ethisphere Institute more than ten times. In recent years, HCA Healthcare spent an estimated $3.7 billion in cost for the delivery of charitable care, uninsured discounts, and other uncompensated expenses.

If this opportunity is your next step in your career path, we encourage you to apply for our RN Case Manager opening. We review all applications. Qualified candidates will be contacted by a member of our team. We are interviewing, apply today!

We are an equal opportunity employer. We do not discriminate on the basis of race, religion, color, national origin, gender, sexual orientation, age, marital status, veteran status, or disability status.