Case Manager

Townsen Memorial Hospital is looking for a Case Manager to join our team!

The Case Manager will be responsible for intake and case management services for the facility patients, develop plans for patient self-care, and discharge planning by primary contact, or telephone contact. The case manager promotes the CMS core measures and monitors compliance of such with educating the facility staff. Additionally, the Case Manager will be responsible for the clinical updates to third parties and collecting and reporting of quality metrics as assigned.

Essential Functions

• Assess the physical, functional, social, psychological, environmental, learning and financial needs of patients
• Identify problems, goals and interventions designed to meet patient’s needs, including prioritized goals that consider the patient/caregivers goals, preferences and desired level of involvement in the case management plan
• Create care plan including objectives, goals and actions designed to meet patient’s needs
• Provide appropriate interventions which demonstrate knowledge of and sensitivity toward cultural diversity and religious, developmental, health literacy, and educational backgrounds of the population served. Utilize interpreter services per policy
• Assess the patient’s formal and informal support systems, including caregiver resources and involvement as well as available benefits and/or community resources
• Implement and monitor the care plan to ensure the effectiveness and appropriateness of services
• Evaluate patient’s progress toward goal achievement, including identification and evaluation of barriers to meeting or complying with case management plan of care, and systematically reassess for changes in goals and/or health status
• Research alternative treatment options and selecting and locating appropriate providers which can include facilitation of referrals
• Communicates with primary care physician and members of the comprehensive care team regarding status of patient
• Utilize motivational interviewing skills to build patient engagement in case management plan of care
• Provide education, information, direction and support related to care goals of patients
• Act as a patient advocate and assist with problem solving and addressing any barriers to care or compliance with care plan
• Coordinate care and develop treatment plans
• Provide referrals to appropriate community resources; facilitate access and communication when multiple services are involved; monitor activities to ensure that services are actually being delivered and meet the needs of the patient, coordinate services to avoid duplication
• Maintain accurate patient records and patient confidentiality
• Measure outcomes and effectiveness of case management including clinical, financial, quality of life and
  
  

patient/family satisfaction

• Engage in professional development activities to keep abreast of case management practices and patient engagement strategies
• Facilitate disease prevention and health promotion with patients and families
• Determine psychosocial needs & complex medical needs of all patients
• Participate in prospective, concurrent, and retrospective case reviews involving targeted patients
• Apply all internal criteria and guidelines used to make the determination if care management is improving outcomes
• Identify risk factors and teach patients clear pathway of response to identified triggers
• Promote patient and family responsibility and self-management
• Document all relevant information following department policy guidelines
• Maintain knowledge of operational procedures and case management program components
• Promote chronic disease management concepts, health screening and preventive health initiatives for targeted patients
• Participate and promote appropriate performance improvement projects
• Develop, implement, and evaluate department initiatives and goals as assigned
• Assist with the collection, analysis, and benchmarking of utilization data
• Collaborate in the development of protocols and guidelines for patient care management
  
  

Knowledge, Skills, And Abilities

• Strong organizational and interpersonal skills
• Ability to determine appropriate course of action in more complex situations.
• Ability to work independently, exercise creativity, be attentive to detail, and maintain a positive attitude.
• Ability to manage multiple and simultaneous responsibilities and to prioritize scheduling of work.
• Ability to maintain confidentiality of all medical, financial, and legal information.
• Ability to complete work assignments accurately and in a timely manner.
• Ability to communicate effectively, both orally and in writing.
• Ability to handle difficult situations involving patients, physicians, or others in a professional manner.
  
  

Education And Experience

• Graduate from an accredited school of nursing.
• Registered Nurse in the State of Texas; License must remain active and unencumbered while employed.
• Basic Life Support (BLS) certified or must be obtained within thirty (30) days of hire.
• Two (2) years of experience with case management and InterQual Criteria
• Two (2) years of core measure abstraction and case management
• Case Management certification preferred
  
  

Townsen Memorial Hospital is an accredited network of facilities with an emphasis on emergency care, outpatient surgery, and diagnostics and imaging. Our core mission is to provide compassionate, evidence-based patient care to those we serve. At Townsen Memorial, we encompass diversity, dignity, and inclusiveness as a reflection of our core values. Townsen Memorial is committed to driving cutting edge healthcare to our patients, our communities and each other.

Compensation to be determined by the education, experience, knowledge, skills, and abilities of the applicant, internal equity, and alignment with market data.

Employment for this position is contingent upon the successful completion of a background check and drug screening.