RN Case Management Manager | Lead Patient Care & Care Transitions

The Staff Pad is proud to partner with a respected
healthcare organization in Hamilton, TX to recruit an experienced Case
Management Manager who is passionate about improving patient outcomes, leading
high-performing teams, and ensuring safe, efficient transitions of care.

The Case Management Manager leads and supports the
Case Management team in coordinating patient care from admission through
discharge. This role collaborates closely with physicians, nursing staff, and interdisciplinary
teams to remove barriers to timely discharge, improve patient outcomes, ensure
regulatory compliance, and promote cost-effective care while maintaining the
highest standards of patient advocacy

What You’ll Do

Key Responsibilities

• Conduct
  discharge assessments on admission & develop timely, appropriate
  discharge plans
  
• Perform
  daily patient assessments, monitor, evaluate & document patient
  progress
  
• Coordinate
  post-hospital care & coordinate discharge to home and other care
  settings
  
• Provide,
  document, and coordinate patient and family education; serve as liaison
  among patients, families, physicians, and the care team
  
• Document
  discharge services accurately and timely in accordance with hospital
  policy
  
• Maintain
  individualized patient care plans and update them based on changes in
  patient status
  
• Review
  denials, identify appeal needs, and ensure appropriate appeal completion
  
• Review
  continued stay, medical necessity, medical reports and treatment plans
  
• Facilitate
  access to financial assistance, advance directives, legal aid, education
  and medication assistance programs
  
• Coordinate
  patient care and rehabilitation using consultation findings and social
  work expertise
  
• Partner
  with Quality Improvement to enhance patient safety, establish goals, and
  submit monthly quality reports
  
• Review
  payer-requested charts and communicate clinical information to payers
  
• Maintain
  referral source database & refer patients, families to community
  resources
  
• Identify
  barriers to patient progress & perform social work duties as needed
  
• Document
  ongoing physiological, psychosocial assessments, patient and family
  education and responses & interdisciplinary care plan recommendations
  
• Validate,
  transcribe, and co-sign physician orders; report patient progress, and
  advise physicians and departments on utilization management regulations
  
• Perform
  utilization reviews in compliance with state regulations and evolving
  utilization management regulations
  
• Monitor
  daily case management needs & maintain collaborative staff
  relationships
  
• Communicate
  discharge plans with physicians and complete follow-up calls within three
  days of discharge
  

Additional Responsibilities

• Assist
  with coordinating quarterly utilization review committee activities and
  updating policies and procedures
  
• Perform
  registered nurse duties in accordance with the RN job description
  
• Maintain
  confidentiality and HIPAA compliance when handling sensitive information
  
• Adhere
  to organizational behavioral standards personnel policies and customer
  service expectations
  
• Perform
  other duties as assigned
  

What We Are Looking For

Qualifications

• Graduate
  of an accredited School of Nursing
  
• RN
  license in the State of Texas, Current CPR, BLS certification; ACLS
  preferred
  
• 5+
  years of Registered Nurse experience; Case Management leadership
  experience preferred
  
• Knowledge
  of utilization management, discharge planning, and regulatory requirements
  

Additional Requirements

• Compassionate
  and patient-focused leadership
  
• Excellent
  communication, relationship-building, clinical judgement and
  problem-solving skills
  
• Commitment
  to quality, safety, and continuous improvement
  
• Ability
  to multitask and perform in a fast-paced environment
  
• Ability
  to stand, walk, bend, lift up-to 50 pounds, and assist patients as needed
  

What You Can Expect

• Paid
  Time Off & Holidays
  
• Health
  & Supplemental Insurance
  
• Direct
  Deposit
  
• Fitness
  Center Membership
  
• Education
  Reimbursement
  
• Retirement
  Plan
  

If you're a collaborative nurse leader who thrives
in a fast-paced acute care environment looking to lead a dedicated Case
Management team while making a lasting impact on patients and their families,
we encourage you to apply today!