Case Manager Advanced (RN) - Emergency Room

Houston Methodist Baytown Hospital is a premier healthcare provider located in Baytown, Texas, that brings the expertise and advanced medical technology of the renowned Houston Methodist health system to the local community and surrounding counties. This state-of-the-art facility is staffed by a dedicated team of physicians, nurses, and healthcare professionals committed to delivering exceptional, patient-centered care close to home. The hospital has been actively expanding its campus with a comprehensive facilities master plan that includes an expanded emergency department, a new five-story patient tower, an outpatient center, a renovated Cancer Center, a neonatal intensive care unit, and the addition of technologically advanced operating rooms. This ongoing investment demonstrates Houston Methodist Baytown’s commitment to growth and innovation, ensuring access to high-quality healthcare services in a rapidly growing region.

The Case Manager Advanced position at Houston Methodist Baytown Hospital is a critical role within the hospital’s care coordination team, designed for seasoned nursing professionals with extensive clinical and case management expertise. This advanced level case management role focuses on promoting optimal clinical outcomes and the efficient use of healthcare resources, particularly concentrating on complex cases and patients requiring multi-visit assessments within the emergency room and throughout hospitalization. The position is responsible for ensuring appropriate length of stay and reimbursement for hospital admissions while aligning with organizational goals. This role requires the analysis of clinical variances to identify opportunities for process improvements and optimal care transitions, positioning the case manager as a key resource and educator for interdisciplinary teams, patients, and families.

In addition to fulfilling the responsibilities of a certified case manager, the Advanced Case Manager demonstrates expert knowledge in discharge planning, utilization management, healthcare laws, ethics, and payer requirements. The position acts as a mentor and leader, providing guidance to other case management staff and stepping in as a primary resource during management absences. The role participates actively in special projects related to patient throughput, readmissions, and utilization management, contributing to broader departmental and hospital initiatives that improve patient care quality and operational efficiency.

This exempt position involves close collaboration with physician leadership and multidisciplinary teams to develop and implement clinical pathways and care management programs tailored to specific patient populations, aiming to enhance patient satisfaction and reduce costs. The position also encompasses responsibilities that support quality and safety functions by conducting audits, managing documentation compliance, and leading efforts to reduce length of stay and readmission rates. With its emphasis on growing and educating team members, the role promotes continuous professional development and engagement initiatives. Business professional attire is required, and the position involves occasional on-call duties and travel within the Houston metropolitan area. Candidates are expected to hold a Bachelor’s degree in nursing, with a Master’s degree preferred, and to possess a minimum of seven years clinical nursing experience, including five years in case management, alongside the appropriate Texas RN licensure and recognized case management certification.