Comprehensively plans for case management services for a targeted patient population. Carries out activities related to utilization management, discharge planning, care coordination and referral to other levels of care. Work with physicians, Social Workers with the interdisciplinary team to facilitate clinical pathways and achievement of desired treatment outcomes. Promotes interdisciplinary collaboration and champion service excellence. Works collaboratively to ensure patient needs are met and care delivery is coordinated across the continuum at the appropriate level of care.
1. Clinical expertise.
2. Excellent interpersonal communication and negotiation skills.
3. Strong analytical, data management and computer skills.
4. Current working knowledge of discharge planning, utilization management, case management, performance improvement and managed care reimbursement.
5. Able to work with people of all social, economic, and cultural backgrounds.
6. Flexible, open-minded and adaptable to change.
7. Understanding of pre-acute and post-acute venues of care and community resources.
8. Strong organizational and time management skills, as evidenced by capacity to prioritize multiple tasks and role components.
9. Ability to work independently and exercise sound judgment in interactions with physicians, payors, and patients/families.
10. Bilingual English/Spanish preferred, culturally sensitive.
11. Ability to read and comprehend English at a level necessary to follow written and oral instructions and safety precautions.
A. Work Experience:
1. Five years of direct patient care experience in an acute care setting.
2. Previous case management experience or related experience preferred.
1. Current Texas RN License.
2. Certified Case Manager (CCM) preferred.
C. Education and Training:
Bachelors Degree in Nursing required, MSN preferred.