Overview

JOB SUMMARYAt Houston Methodist, the Case Manager PRN (CM) position is a licensed registered nurse (RN) who comprehensively plans for case management of a target patient population on a designated unit(s). This position works with the physicians and interprofessional health care team to facilitate and maintain compassionate, efficient quality care and achievement of desired treatment outcomes. The CM PRN holds joint accountability with social worker for discharge planning and continuity of care and assures that admission and continued stay are medically necessary and communicates clinical information to payors to ensure reimbursement. The CM PRN helps drive change by identifying areas where performance improvement is needed (e.g., day-to-day workflow, education, process improvements, patient satisfaction).

Houston Methodist Standard

PATIENT AGE GROUP(S) AND POPULATION(S) SERVEDRefer to departmental "Scope of Service" and "Provision of Ca" plans, as applicable, for description of primary age groups and populations served by this job for the respective HM entity.

HOUSTON METHODIST EXPERIENCE EXPECTATIONS

• Provide personalized care and service by consistently demonstrating our I CARE values:
• INTEGRITY: We are honest and ethical in all we say and do.
• COMPASSION: We embrace the whole person including emotional, ethical, physical, and spiritual needs.
• ACCOUNTABILITY: We hold ourselves accountable for all our actions.
• RESPECT: We treat every individual as a person of worth, dignity, and value.
• EXCELLENCE: We strive to be the best at what we do and a model for others to emulate.
• Focuses on patient/customer safety
• Delivers personalized service using HM Service Standards
• Provides for exceptional patient/customer experiences by following our Standards of Practice of always using Positive Language (AIDET, Managing Up, Key Words)
• Intentionally rounds with patients/customers to ensure their needs are being met
• Involves patients (customers) in shift/handoff reports byenabling their participation in their plan of care as applicable to the given job

Responsibilities

PRIMARY JOB RESPONSIBILITIESJob responsibilities labeled EF capture those duties that are essential functions of the job.PEOPLE - 10%

• completion and reporting of diagnostic testing; b. completion of treatment plan and discharge plan; c. modification of plan of care, as necessary, to meet the ongoing needs of the patient; d. assignment of appropriate levels of care; e. completion of all required documentation in EPIC and MIDAS (EF)

SERVICE - 20%

QUALITY/SAFETY - 30 %

• compliance with established governmental and/or institutional rules and regulations
• analysis of problematic areas, and
• actions taken to improve compliance (EF)

FINANCE - 25%

GROWTH/INNOVATION - 15%

This job description is not intended to be all inclusive; the employee will also perform other reasonably related business/job duties as assigned. Houston Methodist reserves the right to revise job duties and responsibilities as the need arises.

Qualifications

EDUCATION REQUIREMENTS

• Graduate of education program approved by the credentialing body for the required credential(s) indicated below in the Certificates, Licenses and Registrations section.

EXPERIENCE REQUIREMENTS

• Three (3) years hospital clinical nursing experience which includes two (2) years in case management

License/Certification

CERTIFICATES, LICENSES AND REGISTRATIONS REQUIRED

• Texas RN license or temporary TX RN license, should obtain permanent license within 90 days. Compact license acceptable according to current Board of Nursing requirements.

KSA/ Supplemental Data

KNOWLEDGE, SKILLS AND ABILITIES REQUIRED

• Demonstrates the skills and competencies necessary to safely perform the assigned job, determined through on-going skills, competency assessments, and performance evaluations.
• Sufficient proficiency in speaking, reading, and writing the English language necessary to perform the essential functions of this job, especially with regard to activities impacting patient or employee safety or security.
• Ability to effectively communicate with patients, physicians, family members and co-workers in a manner consistent with a customer service focus and application of positive language principles.
• Strong assessment, organizational and problem-solving skill as evidenced by capacity to prioritize multiple tasks and role components
• Knowledge of Medicare, Medicaid and Managed Care requirements
• Comprehensive knowledge of community resources, health care financial and payer requirements/issues, and eligibility for state, local and federal programs
• Comprehensive knowledge of discharge planning, utilization management, case management, performance improvement and managed care reimbursement.
• Understanding of pre-acute and post-acute venues of care and post-acute community resources.
• Ability to work independently
• Strong assessment, organizational and problem-solving skill as evidenced by capacity to prioritize multiple tasks and role components
• Demonstrates critical thinking and makes decisions using evidence-based analytical approach in interactions with physicians, payors, and patients and their families
• Well versed in computer skills of the entire Microsoft Office Suite (Access, Excel, Outlook, PowerPoint and Word)

SUPPLEMENTAL REQUIREMENTS

*Note that employees may be required to be on-call during emergencies (ie. Disaster, Severe Weather Event, etc) regardless of selection above.Travel**

**Travel specifications may vary by department.

• Please note any other special considerations to this job: Must be able to commit to at least two shifts a month

Company Profile

Houston Methodist Willowbrook Hospital opened in December 2000 to serve the comprehensive health care needs of the growing community in Northwest Houston. The 310 bed hospital has 23 operating rooms, and more than 2,100 employees. Houston Methodist Willowbrook Hospital has been named a Magnet recognized health care facility by the American Nurses Credentialing Center’s (ANCC) Magnet Recognition Program®. Houston Methodist Willowbrook Hospital is Northwest Houston's regional leader in robotic minimally-invasive surgeries and specializes in cardiology and cardiovascular services, neurology, neurosurgery, orthopedics and sports medicine, and comprehensive cancer services. Houston Methodist Willowbrook Hospital has a Breast Care Center, Cancer Center, Imaging Center, Infusion Center, Sleep Center, Surgical Weight Loss Center and operates the largest Childbirth Center in the greater Northwest Houston area.