Case Manager

Memorial Hermann - Sugar Land, TX

Full-time - Mid Level

Sugar Land, TX

Hospitals

About the position

The Case Manager position at Memorial Hermann Health System is designed to support physicians and interdisciplinary teams in facilitating patient care. The role focuses on enhancing clinical outcomes and patient satisfaction while managing care costs. Responsibilities include coordinating resource utilization, care facilitation, and discharge planning, as well as identifying areas for performance improvement. The Case Manager is accountable for a designated patient caseload, ensuring effective planning to meet patient needs and promote efficient resource utilization.

Responsibilities

• Coordinates and facilitates patient care progression throughout the continuum.
• Works collaboratively with physicians, nursing, and other members of the multi-disciplinary care team.
• Addresses and resolves system problems impeding diagnostic or treatment progress.
• Proactively identifies and resolves delays and obstacles to discharge.
• Seeks consultation from appropriate disciplines/departments to expedite care and facilitate discharge.
• Utilizes advanced conflict resolution skills to ensure timely resolution of issues.
• Monitors patient progress and intervenes as necessary to ensure patient-focused care.
• Completes and reports diagnostic testing, treatment plans, and discharge plans in a timely manner.
• Communicates with third party payors and other relevant information to the care team.
• Completes all required documentation in TQ screens and patient records.
• Collaborates with medical staff and ancillary staff to eliminate barriers to efficient care delivery.
• Completes Utilization Management and Quality Screening for assigned patients.
• Identifies at-risk populations using approved screening tools and follows established reporting procedures.
• Manages all aspects of discharge planning for assigned patients.
• Meets with patients/families to assess needs and develop individualized continuing care plans.
• Facilitates transfer to other facilities as appropriate.
• Participates in clinical performance improvement activities.
• Assists in the collection and reporting of financial indicators related to case management.

Requirements

• Graduate of an accredited school of professional nursing or Master of Social Work program.
• Current and valid license to practice as a Registered Nurse or Master Social Worker in Texas.
• Certification in Case Management required within two years of hire.
• Three years of nursing or social work experience in an acute hospital-based setting or comparable clinical setting.
• Experience in utilization management, case management, or discharge planning preferred.
• Excellent interpersonal communication and negotiation skills.
• Demonstrated leadership skills and strong analytical abilities.
• Current working knowledge of discharge planning, utilization management, and managed care reimbursement.
• Understanding of pre-acute and post-acute care venues and community resources.
• Strong organizational and time management skills.

Nice-to-haves

• Experience in a Federally Qualified Health Clinic (FQHC) or skilled nursing facility.
• Knowledge of motivational interviewing and change management.

Benefits

• Health insurance coverage
• Dental insurance coverage
• 401k retirement savings plan
• Paid time off (PTO)
• Continuing education support
• Professional development opportunities