Manager (RN) Case Management

Location : Houston, TX

Job Type : Direct

Reference Code : RN Case Management - HCA

Hours : Full Time

Required Years of Experience : 1

Required Education : BSN

Travel : No

Relocation : Yes

Job Industry : Healthcare - Health Services

Job Description :

We are currently recruiting a full-time RN Case Manager to join a dynamic team and facility within the Houston, TX area. This is full-time with no weekends. Position offers a competitive salary and robust recruitment package. Please forward an updated resume to: isteadman@virtusplacement.com if you are interested in discussing.

Job Responsibilities:

Reports directly to the Director of Case Management and provides oversight to the Case management team.

Responsible for coordinating, monitoring, executing and evaluating Case Management Department activities.

Accountable for assisting hospital utilization performance improvement in order to promote effective utilization of hospital resources, ensure processes support appropriate reimbursement for services rendered, support efficient patient throughput, and ensure compliance with all state and federal regulations related to case management services.

Utilization Management supporting medical necessity and denial prevention

Transition Management promoting appropriate length of stay, readmission prevention and patient satisfaction

Care Coordination by demonstrating throughput efficiency while assuring care is the right sequence and at appropriate level of care

Compliance with state and federal regulatory requirements, TJC accreditation standards and HCA policy

Education provided to physicians, patients, families and caregivers

Required Qualifications :

Education:

Registered Nurse with active license; BSN required.

Experience:

One year acute hospital case management leadership experience preferred.

McKesson InterQual® experience preferred.

Two years acute hospital case management experience preferred.

Certification:

Accredited Case Manager (ACM) preferred.