Case Manager Advanced (RN) - ED

At Houston Methodist, the Case Manager (CM) Advanced position is a registered nurse (RN) responsible for promoting the achievement of optimal clinical and resource outcomes, accountable for a designated assignment that is considered more complex and resource intensive. This position has achieved an expert level at all the objectives delineated in the Case Manager and Case Manager Certified job roles and is responsible for facilitating appropriate lengths of stay (LOS) and reimbursement for all hospital admissions in accordance with set goals and objective. The CM Advanced position assures that admission and continued stay are medically necessary, communicating clinical information to payers to ensure reimbursement. The Advanced CM position analyzes variances to identify opportunities for improvement and acts as the key information and education resource for the interprofessional health care team. This position promotes and maintains compassionate, quality of care through collaboration with all service team members, patients and families and works with the leadership team for special project activities related but not limited to, throughput, readmissions, and utilization management to align with the visions and goals of the department and organization. The CM Advanced position will lead projects or perform specialized responsibilities as a regular part of their normal job responsibilities.

Requirements:

Qualifications:

LICENSES AND CERTIFICATIONS - REQUIRED

• RN - Registered Nurse - Texas State Licensure and/or Compact State Licensure within 60 days OR
• RN-Temp - Registered Nurse - Temporary State Licensure within 60 days AND
• Magnet - ANCC Recognized Certification -- Case Management-related OR
• ACM - Accredited Case Manager (NBCM) -- National Board for Case Management

KNOWLEDGE, 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

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

• Strong assessment, organizational and problem-solving skill as evidenced by capacity to prioritize multiple tasks and role components

• Knowledge of community resources, health care financial and payer issues, Medicare, Medicaid and Managed Care requirements and eligibility for state, local and federal programs

• Skill-specific areas include: regulatory requirements, pathway development/ implementation, ethics/healthcare law, clinical skill, etc.

• Expert 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

• Proficient in computer skills of the entire Microsoft Office Suite (Access, Excel, Outlook, PowerPoint and Word)

• Required passage of Interrater Reliability test (IRR)

SUPPLEMENTAL REQUIREMENTS

WORK ATTIRE

• Uniform No
• Scrubs No
• Business professional Yes
• Other (department approved) No

ON-CALL*
*Note that employees may be required to be on-call during emergencies (ie. DIsaster, Severe Weather Events, etc) regardless of selection below.

• On Call* Yes

TRAVEL**
**Travel specifications may vary by department**

• May require travel within the Houston Metropolitan area Yes
• May require travel outside Houston Metropolitan area No

Company Profile:

Houston Methodist Baytown Hospital brings the expertise and latest technology of Houston Methodist to Baytown and surrounding counties. The skilled and compassionate physicians, nurses and staff provide unsurpassed medical care in a close-to-home, state-of-the-art facility. Houston Methodist Baytown is committed to meeting the needs of its growing community through the ongoing facilities master plan expansion project, which includes a new, expanded emergency department, a five-story patient tower, outpatient center, renovated Cancer Center, neonatal intensive care unit and the addition of technologically advanced operating rooms.

Houston Methodist is an Equal Opportunity Employer.

Equal employment opportunity is a sound and just concept to which Houston Methodist is firmly bound. Houston Methodist will not engage in discrimination against or harassment of any person employed or seeking employment with Houston Methodist on the basis of race, color, religion, sex, sexual orientation, gender identity, national origin, age, disability, status as a protected veteran or other characteristics protected by law. VEVRAA Federal Contractor – priority referral Protected Veterans requested.