Case Management Manager

Case Management Manager -

Trauma Location:

Houston, TX 77030 (Onsite - Candidates must report in person) Job Description Job Description Summary The Manager of Case Management is responsible and accountable to assist the Director of Case Management in the implementation of the case management program at the local level. The components/roles of the inpatient case management program consist of the following: Care Facilitation, Utilization Management, Case Management and Discharge Planning. The Manager is responsible for coordinating the use systems and processes for care/utilization management at the hospital level. In addition, the Manager is responsible for assisting the Director in managing the department's activities related to discharge planning and clinical quality improvement. The Manager coordinates day-to-day departmental operations and the use of hospital resources appropriately and effectively. The Manager participates in the collection, analysis and reporting of financial and quality data related to utilization management, quality improvement and performance improvement.

Minimum Qualifications Education:

Bachelor's of Science in Nursing OR Social Work (BSW). Master's degree preferred.

Licenses/Certifications:

Current and valid license to practice as a Registered Nurse in the state of Texas OR Licensed Master Social Worker (LMSW) required, LCSW preferred Case Manager Certification required

Experience/Knowledge/Skills:

Minimum five (5) years' experience in utilization management, case management, discharge planning or other cost/quality management program Three (3) years of experience in hospital-based nursing or social work Three (3) years of demonstrated leadership experience Knowledge of leading practice in clinical care and payor requirements Self-motivated, proven communication skills, assertive Background in business planning and targeted outcomes Working knowledge of managed care, inpatient, outpatient, and home health continuum, as well as utilization management and case management Working knowledge of Performance Improvement concepts Demonstrated effective working relationship with physicians Ability to work collaboratively with healthcare professionals at all levels Effective oral and written communication skills Principal Accountabilities Assists in supervising and managing all aspects of the local level program. Supports growth and development of the case management program consistent with enterprise-wide philosophy and in response to the dynamic nature of the healthcare environment through benchmarking, networking, quality management, and other activities as needed. Responsible for coordinating day-to-day operations of the program at the unit level. Assists in identifying and achieving optimal targeted financial outcomes via the inpatient case management process. Participates in departmental personnel functions (hiring, firing, etc.) in conjunction with the Director of Case Management. Provides input to annual and interim performance appraisal reviews for professional and non-professional staff. Acts as liaison to facilitate communication and collaboration between physicians, hospitalists, community care managers, nurses, community resources, and other care partners. Responsible for leading a high-performance team of system thinkers who incorporate leadership principles and vision in performing case management functions. Uses data to drive decisions and implement performance improvement strategies. Ensures safe care to patients, staff, and visitors while adhering to organizational policies and standards. Promotes professional growth and development through continuing education and competency requirements. Supports department-based goals that contribute to organizational success. Demonstrates commitment to compassionate and personalized patient care experiences. Other duties as assigned. Must-Have Requirements Case Manager Certification required Current and valid Texas RN License OR Licensed Master Social Worker (LMSW) LCSW preferred Minimum 5 years of experience in utilization management, case management, discharge planning, or other cost/quality management programs Minimum 3 years of hospital-based nursing or social work experience Minimum 3 years of demonstrated leadership experience

Sign-On Bonus:

None Management Incentive Plan (MIP) The MIP currently provides a payout at a target of 10% of your base salary with a maximum payout of 15%.