Responsibilities

The Manager of Case Management is responsible for the supervision of the following functions: Case Management, Care Coordination, Social Services, Discharge Planning, and Utilization Review. The Manager will assure that the department performs the following functions: assessment, discharge planning, implementation, coordination, monitoring, and evaluation of the care of patients in the facility, through the continuum of care. Functions as a resource person for supervisory staff members and assists in necessary education of individual supervisory members of staff. The Manager will coordinate with her staff to guarantee facilitation and collaboration with physicians, patients, families, and payers, as well as the multidisciplinary healthcare team to maximize efficient utilization of the patient and hospital resources to promote quality, cost-effective outcomes.

Qualifications

MINIMUM EDUCATION:

Graduate from an accredited nursing school

MINIMUM WORK EXPERIENCE:

Three to five years management experience in Case Management in an acute care setting, with a certificate in Case Management (CCM). CPUR or other certification a plus, but not required.

REQUIRED LICENSES/CERTIFICATIONS:

Current licensure in Texas as a Registered Nurse. CCM - CPUR or other certification a plus but not required.

REQUIRED SKILLS, KNOWLEDGE, AND ABILITIES:

Proficient in data analysis. Must possess clinical and communication skills necessary to assist with the strategic planning for the management of clinical and financial risk. Self-directed, and able to work independently. Exercise sound judgment, discretion and initiatives. Demonstrates a positive professional and personal image. Maintains confidentiality. Basic typing skills and computer knowledge. In-depth knowledge of Interqual, Commercial Insurance, Medicare and Medicaid regulations.