Case Manager - Transition in Care

Houston Methodist is recognized as one of the nation’s leading health systems and academic medical centers. Comprising eight hospitals—including the flagship Houston Methodist Hospital located in the Texas Medical Center, seven community hospitals, and a long-term acute care hospital—the system serves the Greater Houston metropolitan area with comprehensive healthcare services. In addition to its hospital network, Houston Methodist encompasses a research institute, a wide-ranging residency program, international patient services, and numerous outpatient clinics such as emergency care and imaging centers. This extensive infrastructure supports Houston Methodist’s commitment to delivering high-quality, compassionate, and innovative patient care across a diverse population. The health system's reputation for excellence is reflected through its cutting-edge clinical programs, ongoing research endeavors, and dedication to community health improvement initiatives.

The role of Case Manager (CM) at Houston Methodist is a registered nurse (RN) position focused on comprehensive clinical assessments and the orchestration of case management, including care transitions and discharge planning specific to designated patient populations within selected units or service lines. This position is critical in facilitating and coordinating clinical care through collaboration with physicians and multidisciplinary healthcare teams, aiming to ensure efficient, safe, and quality patient outcomes. The CM holds joint accountability with social workers for discharge planning, care coordination, and patient throughput while assuring admissions and continued stay meet medical necessity criteria.

In this role, the Case Manager effectively communicates vital clinical information to payors and post-acute care providers, emphasizing the safe transition and continuity of care from hospital to community settings. Key responsibilities include routinely assessing patient conditions, reviewing medical records to support medical necessity and discharge readiness, initiating referrals for post-acute services such as home health care and hospice, and actively participating in multidisciplinary rounds to identify and resolve barriers to patient throughput. The position demands strong knowledge of healthcare financial and payor requirements, Medicare and Medicaid regulations, and post-acute care resources. The CM is expected to apply critical thinking and evidence-based approaches to modify patient care plans dynamically and promote efficient resource utilization, contributing directly to department and hospital performance and financial targets.

This role requires exceptional communication skills to engage patients, families, physicians, and care teams in a positive, customer-focused manner. The Case Manager supports patients and families by addressing clinical and ethical concerns, delivering education about disease processes impacting health and readmission risk, and linking them with community resources. The CM must possess competencies in multiple areas, including discharge planning, utilization management, managed care reimbursement, and care coordination across various healthcare settings. Proficiency in Microsoft Office applications and the ability to work independently while exercising sound judgment are also essential.

Additional role expectations include participating in performance improvement projects to enhance clinical practices, proactively identifying process improvement opportunities grounded in evidence-based literature, and pursuing professional development through self-assessment and management collaboration. The role is classified as exempt and requires business professional attire. Candidates should be prepared for on-call duties during emergencies and occasional travel within the Houston metropolitan area.

If you are a dedicated registered nurse with a passion for case management, facilitating seamless patient transitions, and contributing to one of the nation’s top healthcare systems, Houston Methodist offers a rewarding career with a supportive and dynamic work environment. Join Houston Methodist to advance your professional growth while making a meaningful impact on patients’ lives and community health outcomes.