Assistant Registered Nurse (RN) - Case Management - $45+ per hour

Memorial Hermann Health System is seeking a Registered Nurse (RN) Case Management Assistant for a nursing job in Houston, Texas.
Job Description & Requirements Specialty: Case Management
Discipline: RN
Duration: Ongoing
36 hours per week
Shift: 12 hours, days, nights
Employment Type: Staff

At Memorial Hermann, we pursue a common goal of delivering high quality, efficient care while creating exceptional experiences for every member of our community. When we say every member of our community, that includes our employees. We know that when our employees feel cared for, heard and valued, they are inspired to create moments that exceed expectations, while prioritizing safety, compassion, personalization and efficiency. If you want to advance your career and contribute to our vision of creating healthier communities, now and for generations to come, we want you to be a part of our team.
Job Summary
Under the general direction of the Case Management Director, the Case Management Assistant provides support to the Case Management team, physicians, and medical office staff office. The CM Assistant facilitates resolution of issues, gathers pertinent information for use by the team, participates in outreach to patients/families, and facilitates processes that promote successful care transitions. Job Description
Minimum Qualifications:
Education : Associate's Degree, preferred.
Licenses/Certifications: One of the following is preferred:

Certified Nursing Assistant (C.N.A)
Licensed Vocational Nurse (L.V.N)
Respiratory Therapist
Certified Medical Assistant
EMT certification by the Texas Department of State Health Services
Licensed Paramedic by the Texas Department of State Health Services

Experience / Knowledge / Skills:
Minimum of one year experience in a health care setting.
Experience working directly with patients, physicians and other caregivers required.
Experience providing patient education in a clinic or outpatient setting preferred.
Ability to demonstrate knowledge of the Medical Home Initiative, and to work with payors, case managers, business office support and others to facilitate the appropriate and cost-effective use of resources.
Proficient in word processing and spreadsheet software with basic knowledge of database applications.
Demonstrate superior written and verbal communication skills and negotiation skills, as well as ability to manage multiple tasks and priorities simultaneously.
Effective oral and written communication skills.

Principal Accountabilities
Participates in the development of patient educational programs, in conjunction with MHMD and CPC subcommittees.
Provides information, guidance and support to the Case Management team relative to the development of individualized plans of care.
Acts as resource to Case Managers in the provision of services on an inpatient and ambulatory basis.
Acts as a liaison between Case Managers and the Medical management team in response to specific program issues.
Maintains current expertise in standards and criteria utilized by third-party payor expectations, and NCQA's Medical Home Standards.
Provides information to CBO for review and update of Insurance Rules screens, in order to assure that timely and accurate contract information is available to Medical Management team at all times.
Tracks denial by type, payor, appeal outcome, documents in appropriate TQ screens, and reports denial trends.
Provides organizational support and input to the MHMD/Inpatient Care Management teams.
Provides denial and non-certified day information to Case Managers to reduce potential denials as appropriate.
In collaboration with physicians and other providers, initiates and delivers denials as appropriate.
In collaboration with the PCP or Physician Advisor, review and provides input into the appeal process as needed.
Provides outreach to patients/families and physicians in accordance with goals set within contractual and clinical outcome metrics.
Ensures quality, safe care to populations managed and targeted within programs at One Memorial Hermann, adhering to policies, procedures, and standards, within budgetary specifications, including time management, supply management, productivity, and accuracy of practice.
Promotes individual professional growth and development by meeting requirements for mandatory/continuing education, skills competency, supports department-based goals which contribute to the success of the organization; serves as preceptor, mentor, and resource to less experienced staff.
Participates in discharge planning activities (e.g. contact with post acute care facilities, other community resources and transportation) as needed to assure safe patient transitions from hospital to home and appropriate linkage to post acute providers.
Participates in performance improvement activities of the department and One Memorial Hermann.
Demonstrates commitment to caring for every member of our community by creating compassionate and personalized experiences. Models Memorial Hermann's service standards by providing safe, caring, personalized and efficient experiences to patients and colleagues.
Other duties as assigned.

Memorial Hermann Health System Job ID #10276_. Posted job title: case management assistant
About Memorial Hermann Health System Company Overview:
Charting a better future. A future that’s built upon the HEALTH of our community. This is the driving force for Memorial Hermann, redefining health care for the individuals and many diverse populations we serve. Our 6,100 affiliated physicians and 29,000 employees practice the highest standards of safe, evidence-based, quality care to provide a personalized and outcome-oriented experience across our more than 270 care delivery sites. As one of the largest not-for-profit health systems in Southeast Texas, Memorial Hermann has an award-winning and nationally acclaimed Accountable Care Organization, 17* hospitals and numerous specialty programs and services conveniently located throughout the Greater Houston area. Memorial Hermann-Texas Medical Center is one of the nation's busiest Level I trauma centers and serves as the primary teaching hospital for McGovern Medical School at UTHealth. For more than 114 years, our focus has been the best interest of our community, contributing more than $411 million annually through school-based health centers and other community benefit programs. Now and for generations to come, the health of our community will be at the center of what we do – charting a better future for all.

*Memorial Hermann Health System owns and operates 14 hospitals and has joint ventures with three other hospital facilities, including Memorial Hermann Surgical Hospital First Colony, Memorial Hermann Surgical Hospital Kingwood and Memorial Hermann Rehabilitation Hospital-Katy.

Our Mission
Memorial Hermann Health System is a non-profit, values-driven, community-owned health system dedicated to improving health.

Our Vision
To create healthier communities, now and for generations to come.

Our Values
Community: We value diversity and inclusion and commit to being the best healthcare provider, employer and partner.
Compassion: We understand our privileged role in people's lives and care for everyone with kindness and respect.
Credibility: We conduct ourselves and our business responsibly and prioritize safety, quality and service when making decisions.
Courage: We act bravely to innovate and achieve world-class experience and outcomes for patients, consumers, partners and the community.
Benefits Dental benefits
Vision benefits
Employee assistance programs
403b retirement plan
Health Care FSA
Dependent Care FSA
School loan reimbursement