RN Case Management Manager: Lead Utilization & Transitions

HCA Houston Healthcare; Houston (TX); On-site; USD 110,000 - 140,000; Full time

Benefits offered by this job

Medical coverage

401(k) match

Paid time off

Job summary

HCA Houston Healthcare Northwest is seeking a Case Management RN Manager to oversee the Case Management Department, coordinating utilization management, transition planning, and education for clinicians and staff. The role ensures efficient throughput, compliance with CMS and TJC standards, and supports appropriate reimbursement for services delivered.

The position reports to the Director of Case Management and collaborates with physicians, patients, families, and caregivers to optimize hospital

Qualifications

• RN license required.
• Bachelor's degree required; Master's preferred.
• 1 year acute hospital case management leadership experience preferred. ACM preferred. McKesson InterQual experience preferred.

Responsibilities

• Oversee Case Management Department activities.
• Coordinate, monitor, and evaluate case management processes.
• Support utilization performance improvement and appropriate reimbursement for services.

Skills

RN license

Leadership experience

ACM

InterQual experience

Education

Bachelor's degree

Master's degree

Tools

McKesson InterQual

Job description

HCA Houston Healthcare Northwest is seeking a Case Management RN Manager to oversee the Case Management Department, coordinating utilization management, transition planning, and education for clinicians and staff. The role ensures efficient throughput, compliance with CMS and TJC standards, and supports appropriate reimbursement for services delivered.

The position reports to the Director of Case Management and collaborates with physicians, patients, families, and caregivers to optimize hospital