Comprehensively plans for case management services for a targeted patient population. Carries out activities related to utilization management, discharge planning, care coordination and referral to other levels of care. The Case Manager works with Physicians, Social Services and interdisciplinary team to facilitate clinical pathways and achievement of desired treatment outcomes. Coordinates and oversees the care and service of patients to achieve desired clinical and resource outcomes. Will provide education and support to patients and families related to their medical condition. Assesses need for continued care for patients, applies utilization review concepts according to federal, state, and JCAHO guidelines.

Required Skills

1. Clinical expertise.
2. Excellent interpersonal communication and negotiation skills.
3. Strong analytical, data management and computer skills.
4. Current working knowledge of discharge planning, utilization management, case management, performance improvement and managed care reimbursement.
5. Able to work with people of all social, economic, and cultural backgrounds.
6. Flexible, open-minded and adaptable to change.
7. Understanding of pre-acute and post-acute venues of care and community resources.
8. Strong organizational and time management skills, as evidenced by capacity to prioritize multiple tasks and role components.
9. Ability to work independently and exercise sound judgment in interactions with physicians, payors, and patients/families.
10. Bilingual English/Spanish preferred, culturally sensitive.
11. Ability to read and comprehend English at a level necessary to follow written and oral instructions and safety precautions.

Required Experience

Work Experience:

• One year of full-time, recent RN acute care hospital experience. Pediatrics experience preferred.
• Previous case management experience preferred.

License/Registration/Certification:

• Current Texas RN License.
• Certified Case Manager preferred.
• Current CPR Certification.

****Education and Training

• Associates degree in Nursing required
• Bachelors of Science in Nursing preferred

1. Clinical expertise.
2. Excellent interpersonal communication and negotiation skills.
3. Strong analytical, data management and computer skills.
4. Current working knowledge of discharge planning, utilization management, case management, performance improvement and managed care reimbursement.
5. Able to work with people of all social, economic, and cultural backgrounds.
6. Flexible, open-minded and adaptable to change.
7. Understanding of pre-acute and post-acute venues of care and community resources.
8. Strong organizational and time management skills, as evidenced by capacity to prioritize multiple tasks and role components.
9. Ability to work independently and exercise sound judgment in interactions with physicians, payors, and patients/families.
10. Bilingual English/Spanish preferred, culturally sensitive.
11. Ability to read and comprehend English at a level necessary to follow written and oral instructions and safety precautions.