Job Overview
Employment Type
Part-time
Benefits
Health Insurance
Dental Insurance
Paid Time Off
Retirement Plan
employee wellness program
Professional Development
Career advancement opportunities
Job Description
Houston Methodist Hospital is recognized by U.S. News & World Report as the No. 1 hospital in Texas and one of America’s "Best Hospitals." As a full-service, acute-care hospital located in the Texas Medical Center and the flagship hospital of Houston Methodist, it has evolved into one of the nation’s largest nonprofit teaching hospitals and a leader in innovative medical research with a comprehensive residency program. Two of Houston Methodist’s primary academic affiliates are among the nation’s leading health care organizations: Weill Cornell Medicine and New York-Presbyterian Hospital. Houston Methodist also has affiliations with Texas A&M University and the University of Houston. Houston Methodist Hospital offers unparalleled care for thousands of patients from around the world.
Houston Methodist is an Equal Opportunity Employer.
The Case Manager (CM) position at Houston Methodist is a registered nurse (RN) role dedicated to comprehensively planning case management, including care transitions and discharge planning of a focused patient population in designated units and/or service lines. This part-time days position involves collaboration with physicians and the interprofessional health care team to facilitate and maintain compassionate, efficient, high-quality care that meets desired treatment outcomes. The Case Manager shares joint accountability with the social worker for discharge planning and continuity of care, ensuring that admissions and continued stays are medically necessary by communicating clinical information to payors for reimbursement purposes.
This role demands strong skills in assessing patients, coordinating care, and navigating the complexities of healthcare financing including Medicare, Medicaid, and managed care requirements. The Case Manager manages the patient’s discharge process, facilitates referrals for home health care, hospice, and durable medical equipment, and supports smooth transitions by consulting with social workers and other team members to address psychosocial needs. Essential to the role is the ability to communicate effectively with patients, families, physicians, and team members, with a focus on positive customer service principles.
Additionally, the Case Manager will regularly participate in Care Coordination Rounds, contribute to quality improvement initiatives, monitor medical necessity and resource utilization, and assist in denial mitigation to optimize reimbursement. The position requires a grasp of evidence-based practices and an ability to independently manage workload while engaging in continuous professional development and innovation. The role also involves occasional on-call responsibilities and travel within the Houston metropolitan area.
The CM position is essential for enhancing patient outcomes, safety, efficiency in patient throughput, and financial sustainability of the hospital services. This role reports as exempt under FLSA classification and expects business professional attire rather than scrubs or uniforms. Overall, the Case Manager at Houston Methodist is a pivotal part of a leading healthcare institution committed to clinical excellence, compassionate care, and innovative practices in nursing case management.
Houston Methodist is an Equal Opportunity Employer.
The Case Manager (CM) position at Houston Methodist is a registered nurse (RN) role dedicated to comprehensively planning case management, including care transitions and discharge planning of a focused patient population in designated units and/or service lines. This part-time days position involves collaboration with physicians and the interprofessional health care team to facilitate and maintain compassionate, efficient, high-quality care that meets desired treatment outcomes. The Case Manager shares joint accountability with the social worker for discharge planning and continuity of care, ensuring that admissions and continued stays are medically necessary by communicating clinical information to payors for reimbursement purposes.
This role demands strong skills in assessing patients, coordinating care, and navigating the complexities of healthcare financing including Medicare, Medicaid, and managed care requirements. The Case Manager manages the patient’s discharge process, facilitates referrals for home health care, hospice, and durable medical equipment, and supports smooth transitions by consulting with social workers and other team members to address psychosocial needs. Essential to the role is the ability to communicate effectively with patients, families, physicians, and team members, with a focus on positive customer service principles.
Additionally, the Case Manager will regularly participate in Care Coordination Rounds, contribute to quality improvement initiatives, monitor medical necessity and resource utilization, and assist in denial mitigation to optimize reimbursement. The position requires a grasp of evidence-based practices and an ability to independently manage workload while engaging in continuous professional development and innovation. The role also involves occasional on-call responsibilities and travel within the Houston metropolitan area.
The CM position is essential for enhancing patient outcomes, safety, efficiency in patient throughput, and financial sustainability of the hospital services. This role reports as exempt under FLSA classification and expects business professional attire rather than scrubs or uniforms. Overall, the Case Manager at Houston Methodist is a pivotal part of a leading healthcare institution committed to clinical excellence, compassionate care, and innovative practices in nursing case management.
Job Requirements
- Graduate of education program approved by the credentialing body
- three years hospital nursing clinical experience
- registered nurse Texas state licensure
- proficiency in English communication
- knowledge of Medicare, Medicaid and Managed Care
- ability to work independently and exercise sound judgment
- well versed in Microsoft Office Suite
- ability to effectively communicate with patients, physicians, family, and co-workers
- strong assessment, organizational and problem-solving skills
Job Qualifications
- Graduate of education program approved by the credentialing body
- bachelor’s degree preferred
- three years hospital nursing clinical experience
- case management experience preferred
- registered nurse with Texas state licensure
- proficient in communication in English
- knowledge of Medicare, Medicaid and managed care
- strong computer skills including Microsoft Office Suite
- strong assessment, organizational and problem-solving skills
Job Duties
- Communicates in an active, positive and effective manner to all health care team members and reports pertinent patient care and family data
- collaborates with interprofessional staff concerning safety data to improve outcomes and safe transition of care
- assesses all patients timely and thoroughly and participates in daily Care Coordination Rounds
- facilitates discharge planning activities and maintains ownership of the discharge process on assigned units
- initiates and facilitates referrals for home health care, hospice, and durable medical equipment
- modifies care based on continuous evaluation and demonstrates clinical problem-solving
- performs review for medical necessity of admission, continued stay and resource use, monitoring appropriateness and managing patients in observation status
Job Criteria
Experience
No experience required
Job Location
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