Case Manager II FT

ScionHealth; Houston (TX); On-site; USD 65,000 - 95,000; Full time

Job summary

Kindred Hospital Houston Medical Center coordinates and facilitates the care of the patient population through effective collaboration with the Interdisciplinary Care Transitions team, ensuring optimum utilization of resources and continuity of care.

The role emphasizes comprehensive assessment, care planning, plan implementation, and evaluation of patient needs, supporting cost-effective management and family engagement.

Qualifications

• 2+ years experience in healthcare setting.
• Experience in case management, utilization review, or discharge planning preferred.
• RN licensure or LCSW/CSWCM certification is preferred or required per role.

Responsibilities

• Coordinate clinical and psycho-social activities with the Interdisciplinary Team and Physicians.
• Monitor all areas of patients’ stay for effective care coordination.
• Refer high-risk patients who would benefit from additional support.
• Participate in interdisciplinary rounds to review goals and resources.
• Collaborate with payors and post-acute providers for discharge planning.

Skills

Interdisciplinary collaboration

Care coordination

Time management

Communication skills

Critical thinking

Education

Nursing diploma/certificate

BSN/MSN/BSW/MSW preferred

RN/LCSW/CSWCM licensure or certification

Tools

Microsoft Office

Job description

Description

Kindred Hospital Houston Medical Center and Acute Rehabilitation Unit (ARU) provide specialized care for patients with complex medical needs. Our long-term acute care hospital (LTACH) offers advanced, hospital-level treatment for chronically and critically ill patients requiring extended stays. In addition, our Acute Rehabilitation Unit is dedicated to helping patients recover from the effects of acute injuries, impairments, or illnesses. With a focus on personalized care, both the LTACH and ARU collaborate with your physician to provide 24/7 clinical care, ensuring continuous support on your path to recovery.

Job Summary

Coordinates and facilitates the care of the patient population through effective collaboration and communication with the Interdisciplinary Care Transitions (ICT) team members. Follows patients throughout the continuum of care and ensures optimum utilization of resources, service delivery and compliance with external review agencies. Provides ongoing support and expertise through comprehensive assessment, care planning, plan implementation and overall evaluation of individual patient needs. Enhances the quality of patient management and satisfaction, to promote continuity of care and cost effectiveness through the integration of functions of case management, utilization review and management, and discharge planning.

Essential Functions

Care Coordination

• Coordinates clinical and/or psycho-social activities with the Interdisciplinary Team and Physicians.
• Monitors all areas of patients’ stay for effective care coordination and efficient care facilitation.
• Remains current from a knowledge base perspective regarding reimbursement modalities, communityresources, case management, psychosocial and legal issues that affect patients and providers of care.
• Appropriately refers high risk patients who would benefit from additional support.
• Serves as a patient advocate. Enhances a collaborative relationship to maximize the patient’s andfamily’s ability to make informed decisions.
• Demonstrates knowledge of the principles of growth and development over the life span and the skillsnecessary to provide age appropriate care to the patient population served.
• Participates in interdisciplinary patient care rounds and/or conferences to review treatment goals, optimizeresource utilization, provide family education and identified post hospital needs. Collaborates with clinicalstaff in the development and execution of the plan of care, and achievement of goals.
• Coordinates with interdisciplinary care team, physicians, patients, families, post-acute providers, payors,and others in the planning of the patients’ care throughout the care continuum.

Knowledge/Skills/Abilities/Expectations

• Knowledge of government and non-government payor practices, regulations, standards andreimbursement.
• Knowledge of Medicare benefits and insurance processes and contracts.
• Knowledge of accreditation standards and compliance requirements.
• Ability to demonstrate critical thinking, appropriate prioritization and time management skills.
• Basic computer skills with working knowledge of Microsoft Office, word-processing and spreadsheetsoftware.
• Excellent interpersonal, verbal and written skills in order to communicate effectively and to obtaincooperation/collaboration from hospital leadership, as well as physicians, payors and otherexternalcustomers
• Demonstrates good interpersonal skills when working or interacting with patients, their families and otherstaff members.
• Approximate percent of time required to travel, 0%
• Must read, write and speak fluent English.
• Must have good and regular attendance.
• Performs other related duties as assigned.

Qualifications

Education

• Postsecondary (Cert/Diploma/Program Grad) from an accredited school of nursing (Required) And
• Bachelor’s Degree in nursing or social work: BSN, MSN, BSW or MSW (Preferred)

Licenses/Certifications

• RN - Registered Nurse - State Licensure and/or Compact State Licensure in the state of practice Upon Hire (Required) Or
• LCSW- License Clinical Social Worker LCSW or LSW Upon Hire (Required) Or
• CSWCM - Social Work Case Manager Certification Upon Hire (Preferred)

Experience

• 2+ years experience in healthcare setting (Required) And
• Prior Experience in case management, utilization review, or discharge planning (Preferred)