RN Case Manager

HCA Healthcare; McKinney (TX); On-site; USD 85,000 - 105,000; Full time

Benefits offered by this job

Comprehensive benefits

Free counseling

Paid time off

401(k) match

Education support

Adoption assistance

Job summary

HCA Healthcare’s Medical City McKinney is seeking an experienced RN Case Manager to coordinate the plan of care, manage length of stay, and ensure safe discharge planning with a multidisciplinary team. You will drive care transitions, education, and access to appropriate resources for patients and families.

The role emphasizes collaboration with Social Services, adherence to InterQual criteria, and advocacy for patient rights across acute care settings in Texas.

Qualifications

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

Responsibilities

• Perform comprehensive psychosocial, medical and discharge assessment
• Reassess patient condition and plan readmission risk mitigation
• Coordinate care plan and discharge with multidisciplinary team
• Ensure post-acute medical needs are appropriate with Social Services
• Refer to Social Services when psychosocial risks are identified
• Involve patient/family in identifying needs and goals
• Evaluate care progression using InterQual and escalation protocols
• Refer to third party payer and disease management programs
• Facilitate patient throughput and care transitions
• Document care plans and coordination activities
• Align needs with resources to ensure safe discharge
• Maintain effective communication with physicians, patients and staff

Skills

RN licensing

Case management

InterQual knowledge

Regulatory compliance

Education

Associate Degree in Nursing

Bachelor's Degree in Nursing

Job description

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.

Job Summary and Qualifications

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

Benefits

• 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 (https://careers.hcahealthcare.com/pages/employee-benefits-and-rewards)

Note:

Eligibility for benefits may vary by location.

Medical City McKinney opened its doors more than 90 years ago. We are a 285+ bed acute care hospital. We serve the residents of McKinney and northern Collin County. Our main campus is a Level III Trauma Center. We provide emergency services at our main campus and at Medical City ER Stonebridge. We have cardiovascular and neurological services. We offer general surgery, orthopedics and women's services. Additionally, a Level II neonatal intensive care unit and behavioral health services. Medical City McKinney is a Primary Stroke Center. We are also a stroke rehabilitation center. We are certified by The Joint Commission for total hip and total knee replacement. We are a part of the Medical City network of hospitals. Patients are ensured access to medical experts and advanced healthcare innovations across the network.

HCA Healthcare has been recognized as one of the Worlds 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.

"The great hospitals will always put the patient and the patient's family first, and the really great institutions will provide care with warmth, compassion, and dignity for the individual."- Dr. Thomas Frist, Sr. HCA Healthcare Co-Founder

Join a family that cares about every stage in your career! We are interviewing candidates for our RN Case Manager opening.

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.