Location: Houston, AL
us as you discover the meaning behind Caring. Connecting. Growing together. The Nurse Case Manager II (NCM) is responsible for patient case management for longitudinal engagement, coordination for discharge planning, transition of care needs and outpatient patient management through the care continuum.
Nurse Case Manager will identify, screen, track, monitor and coordinate the care of patients with multiple co-morbidities and/or psychosocial needs and develop a patients' action plan and/or discharge plan. They will perform reviews of current inpatient services, and determine medical appropriateness of inpatient and outpatient services following evaluation of medical guidelines and benefit
determination. The Nurse Case Manager will provide continuity of care for members to an appropriate lower level of care in collaboration with the hospitals/physician team, acute or skilled facility staff, ambulatory care team, and the member and/or family/caregiver.
The Nurse Case Manager will coordinate, or provide appropriate levels of care under the direct supervision of an RN Manager or MD. Function is responsible for clinical operations and medical management activities across the continuum of care backssing, planning, implementing, coordinating, monitoring and evaluating). This includes case management, coordination of care, and medical management consulting. Function may also be
responsible for providing health education, coaching and treatment decision support for patients.
The Nurse Case Manager will act as an advocate for patients and their families guide them through the health care system for transition planning and longitudinal care. The Nurse Case Manager will work in partnership with an assigned Care Advocate and Social Worker. This is a full-time field base position which requires 25% to 50% traveling around the Houston, TX and counties areas supporting Well Med Patients. Rotating On-Calls Schedule: Rotating on-call shifts are required Primary Responsibilities: May perform telephonic and/or face-to-face backssments Engage patient, family, and caregivers telephonically to assure that a well-coordinated action plan is established and continually backss health status Provide member education to assist with self-management goals; disease management or acute condition and provide indicated contingency plan Identify patient needs, close health care gaps, develop action plan and prioritize goals Utilizing evidenced-based practice, develop interventions while considering member barriers independently Provide patients with " welcome home" calls to ensure that discharged patients' receive the necessary services and resources according to transition plan Conducts a transition discharge backssment onsite and/or telephonically to identify member needs at time of transition to a lower level of care Independently serves as the clinical liaison with hospital, clinical and administrative staff as well as performs a review for clinical authorizations for inpatient care utilizing evidenced-based criteria within our documentation system for discharge planning and/or next site of care needs In partnership with care team triad, make referrals to community sources and programs identified for patients Utilize motivational interviewing techniques to understand cause and effect, gather or review health history for clinical symptoms, and determine health literacy Manages backssments regarding patient treatment plans and establish collaborative relationships with physician advisors, clients, patients, and providers Collaborates effectively with Interdisciplinary Care Team (IDCT) to establish an individualized transition plan and/or action plan for patients Independently confers with UM Medical Directors and/ or Market Medical Directors on a regular basis regarding inpatient cases and participates in departmental huddles Demonstrate knowledge of utilization management processes and current standards of care as a foundation for utilization review and transition planning activities Maintain in-depth knowledge of all company products and services as well as customer issues and needs through ongoing training and self-directed research Manage assigned caseload in an efficient and effective manner utilizing time management skills Enters timely and accurate documentation into designated care management applications to comply with documentation requirements and achieve audit scores of 95% or better on a monthly basis Maintain current licensure to work in state of employment and maintain hospital credentialing as indicated Performs all other related duties as assigned You'll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in.
Required Qualifications: Associate's degree in Nursing Current, unrestricted RN license, (specific to the state of employment)Case Management Certification (CCM) or ability to obtain CCM within 12 months after the first year of employment3+ years of diverse clinical experience; (caring for the acutely ill patients with multiple disease conditions)3+ years of managed care and/or case management experience Proven knowledge of utilization management, quality improvement, and discharge planning Access to reliable transportation and available to work flexible shifts This position requires Tuberculosis screening as well as proof of immunity to Measles, Mumps, Rubella, Varicella, Tetanus, Diphtheria, and Pertussis through lab confirmation of immunity, documented evidence of vaccination, or a doctor's diagnosis of disease Preferred Qualifications: Experience working with psychiatric and geriatric patient populations Knowledgeable in Microsoft Office applications including Outlook, Word, and Excel Ability to read, analyze and interpret information in medical records, and health plan documents Ability to problem solve and identify community resources Possess planning, organizing, conflict resolution, negotiating and interpersonal skills Independently utilizes critical thinking skills, nursing judgement and decision-making skills Able to prioritize, plan, and handle multiple tasks/demands simultaneously At United Health Group, our mission is to help people live healthier lives and make the health system work better for everyone.
We believe everyone-of every race, gender, interactionuality, age, location and income-deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes - an enterprise priority reflected in our mission.
Diversity creates a healthier atmosphere: United Health Group is an Equal Employment Opportunity/Affirmative Action employer and all qualified applicants will receive consideration for employment without regard to race, color, religion, interaction, age, national origin, protected veteran status, disability status, interactionual orientation, gender identity or expression, marital status, genetic information, or any other characteristic protected by law. United Health Group is a drug - free workplace.
Candidates are required to pass a drug test before beginning employment. For more details: jobs-search. org/legal_houston-c423881/registered-nurse-rn-inpatient-case-manager-healthcare-wellmed-houston-texas-houston_i1955391481
for backssing, planning, implementing direct clinical care to assigned patients on a per shift basis, and unit level. The role is responsible for supervision of staff to which appropriate care is delegated. The role is accountable to support CNO to ensure high quality, safe and appropriate nursing care, competency of clinical staff, and appropriate resource management related to patient care.
Job Responsibilities -Active and current registered nurse license in the state of residence/practice -Effective interpersonal and communication skills -Ability to serve as role model and advocate for the professional discipline of nursing Education Required: Graduated from state approved school of
nursing or an accredited school Preferred: Academic degree in nursing (Bachelor's or Master's degree) Certifications Required: Must be currently licensed, certified or registered to practice profession as required by law, regulation in state of practice or policy.
CPR #LI-AB3 230505xyz X Employment practices will not be influenced or affected by an applicant’s or employee’s race, color, religion, interaction (including pregnancy), national origin, age, disability, genetic information, interactionual orientation, gender identity or expression, veteran status or any other legally protected status. Tenet will make reasonable accommodations for qualified individuals with disabilities unless doing so would result in an undue hardship. For more details: jobs-search. org/legal_jasper-c424319/rn-emergency-room-ft-nights-jasper_i1961627238
clinical care to assigned patients on a per shift basis, and unit level. The role is responsible for supervision of staff to which appropriate care is delegated. The role is accountable to support CNO to ensure high quality, safe and appropriate nursing care, competency of clinical staff, and appropriate resource management related to patient care.
Job Responsibilities -Active and current registered nurse license in the state of residence/practice -Effective interpersonal and communication skills -Ability to serve as role model and advocate for the professional discipline of nursing Education Required: Graduated from state approved school of nursing or an accredited school Preferred:
Academic degree in nursing (Bachelor's or Master's degree) Certifications Required: Must be currently licensed, certified or registered to practice profession as required by law, regulation in state of practice or policy.
CPR #LI-AB3 230505xyz X Employment practices will not be influenced or affected by an applicant’s or employee’s race, color, religion, interaction (including pregnancy), national origin, age, disability, genetic information, interactionual orientation, gender identity or expression, veteran status or any other legally protected status. Tenet will make reasonable accommodations for qualified individuals with disabilities unless doing so would result in an undue hardship. For more details: jobs-search. org/legal_jasper-c424319/rn-emergency-room-prn-rotating-jasper_i1961627062
for backssing, planning, implementing direct clinical care to assigned patients on a per shift basis, and unit level. The role is responsible for supervision of staff to which appropriate care is delegated. The role is accountable to support CNO to ensure high quality, safe and appropriate nursing care, competency of clinical staff, and appropriate resource management related to patient care.
Job Responsibilities -Active and current registered nurse license in the state of residence/practice -Effective interpersonal and communication skills -Ability to serve as role model and advocate for the professional discipline of nursing Education Required: Graduated from state approved school of
nursing or an accredited school Preferred: Academic degree in nursing (Bachelor's or Master's degree) Certifications Required: Must be currently licensed, certified or registered to practice profession as required by law, regulation in state of practice or policy.
CPR #LI-AB2 230505xyz X Employment practices will not be influenced or affected by an applicant’s or employee’s race, color, religion, interaction (including pregnancy), national origin, age, disability, genetic information, interactionual orientation, gender identity or expression, veteran status or any other legally protected status. Tenet will make reasonable accommodations for qualified individuals with disabilities unless doing so would result in an undue hardship. For more details: jobs-search. org/legal_jasper-c424319/rn-gi-lab-endoscopy-ft-days-jasper_i1961627236
reporting, goal setting, survey administration, etc. in conjunction with Nursing and Patient Care leadership. This role is also responsible for facilitating collaborative working relationships with partners across the system who each have a role in organizational engagement, retention strategy and program administration (Nursing Professional Development, Talent Acquisition, Human Resources, HR Analytics, Performance Management, Marketing, etc.
). Think you've got what it takes? Responsibilities Develops and implements strategic initiatives, programs, and processes for engaging and retaining diverse nursing & patient care talent Collaborates with system and nursing leadership to review
retention data, develop targeted action plans for identified practice settings, leaders, and patient care talent Fosters relationships and communications with nursing and patient care talent to enable problem identification and resolution, career counseling, alternative solutions to voluntary termination, and development of employee success profile Initiates and maintains relationships with School of Nursing programs/affiliations and conducts onsite and/or virtual visits Designs and deploys campaigns in marketing platforms in collaboration with HR communications Establishes and maintains robust reporting models to track retention and engagement metrics, root cause analysis and trends Collaborates
with HR and hiring leaders to implement workforce strategies which include internal and external benchmarking to further identify drivers around nursing recruitment and retention strategies Identifies opportunities to increase participation and involvement of Human Resources team members and self by promoting team and departmental initiatives as evidenced by verbal, written and behavioral input at team/department meetings or committees and as observed by the management team Actively participates in task forces, committees, and represents senior leadership or any of their areas of responsibility on multidisciplinary teams Qualifications Being fully vaccinated against COVID-19, including any booster dose(s) of the COVID-19 vaccine recommended by the Centers for Disease Control when eligible, is required for all employees at Texas Children's, unless approved for a medical or religious exemption Bachelor's degree required Bachelor's degree in Business Administration, Healthcare Administration, Nursing, or other related healthcare, business, or science field preferred A master's degree in Business Administration, Healthcare Administration, Nursing, or other related healthcare, business or science field may substitute for two years of relevant work experience Company Profile Since 1954, Texas Children's has been leading the charge in patient care, education and research to accelerate health care for children and women around the world.
When you love what you do, it truly shows in the smiles of our patient families, employees and our numerous accolades such as being consistently ranked as the best children's hospital in Texas, and among the top in the nation by U. S. News & World Report as well as recognition from Houston Business Journal as one of this city's Best Places to Work for ten consecutive years. Texas Children's comprehensive health care network includes our primary hospital in the Texas Medical Center with expertise in over 40 pediatric subspecialties; the Jan and Dan Duncan Neurological Research Institute (NRI); the Feigin Center for pediatric research; Texas Children's Pavilion for Women, a comprehensive obstetrics/gynecology facility focusing on high-risk births; Texas Children's Hospital West Campus, a community hospital in suburban West Houston; and Texas Children's Hospital The Woodlands, the first hospital devoted to children's care for communities north of Houston.
We have also created the nation's first HMO for children, established the largest pediatric primary care network in the country and a global health program that is channeling care to children and women all over the world.
Texas Children's Hospital is also academically affiliated with Baylor College of Medicine, one of the largest, most diverse and successful pediatric programs in the nation. To join our community of 14,000 dedicated team members, visit texaschildrenspeople. org for career opportunities. You can also learn more about our amazing culture at infinitepassion. org. At Texas Children's Hospital, diversity, equity, and inclusion are at the core of our values and mission for all of our patients and families that we serve.
We are committed to providing a diverse and inclusive work environment for all faculty, staff and learners throughout our organization. We believe that each member of our one amazing team provides enrichment that allows us to create a lasting legacy for future employees of this great organization. Texas Children's is proud to be an equal opportunity employer. All applicants and employees are considered and evaluated for positions at Texas Children's without regard to mental or physical disability, race, color, religion, gender, national origin, age, genetic information, military or veteran status, interactionual orientation, gender identity, marital status or any other protected Federal, State/Province or Local status unrelated to the performance of the work involved.
For more details: jobs-search. org/legal_houston-c423881/nursing-retention-specialist-houston_i1959775152
