Care Manager -Medical Center (8a-5p)

 
Position: Care Manager -Medical Center (8a-5p)

Job ID: 144068

Location: US-TX-Houston

Department: Care Management

Talent Area: Registered Nurse

Full/Part Time: Full-Time

Regular/Temporary: Regular

Shift: 8a-5p

About Texas Children's Hospital

Since 1954, Texas Children’s has been leading the charge in patient care, education and research to accelerate health care for children and women around the world. When you love what you do, it truly shows in the smiles of our patient families, employees and our numerous accolades such as being consistently ranked as the best children’s hospital in Texas, and among the top in the nation by U.S.News & World Report as well as recognition from Houston Business Journal as one of this city’s Best Places to Work for ten consecutive years. Texas Children’s comprehensive health care network includes our primary hospital in the Texas Medical Center with expertise in over 40 pediatric subspecialties; the Jan and Dan Duncan Neurological Research Institute (NRI); the Feigin Center for pediatric research; Texas Children’s Pavilion for Women, a comprehensive obstetrics/gynecology facility focusing on high-risk births; Texas Children’s Hospital West Campus, a community hospital in suburban West Houston; and Texas Children’s Hospital The Woodlands, a second community hospital opening in 2017. We have also created the nation’s first HMO for children, established the largest pediatric primary care network in the country and a global health program that is channeling care to children and women all over the world. Texas Children’s Hospital is also academically affiliated with Baylor College of Medicine, one of the largest, most diverse and successful pediatric programs in the nation. To join our community of 13,000 dedicated team members, visit texaschildrenspeople.org for career opportunities. You can also learn more about our amazing culture at infinitepassion.org.

Summary:

We are searching for a Care Manager – someone who works well in a fast-paced setting. In this position, you’ll function as a member of the interdisciplinary healthcare team in the provision of patient care with the underlying objectives of enhancing the quality of clinical and financial outcomes and patient satisfaction while managing the plan of care. Within the purview of financial management, pro-actively communicates with members of the healthcare team to ensure appropriate medical necessity for patients in beds; communicates with payers and patient/family/healthcare team regarding payer information as necessary. Ensures that care moves through the episode of care in a timely and efficient manner.

Think you’ve got what it takes?



Responsibilities :

  • Gathers relevant data and obtains further information by interviewing patient/family & performing careful evaluation of the entire situation
  • Identifies actual and potential problems in services and treatments and discusses with the multidisciplinary team
  • Plans and executes patient/family conferences as an interdisciplinary vehicle to evaluate the families understanding and post discharge needs
  • Initiates and implements plan modifications during the episode of hospitalization and for post-acute care through monitoring and re-evaluation to accommodate changes in treatment or progress
  • Anticipates potential variances in the plan of care and incorporates contingency plans for each step in the process to offset treatment & service delays (Plan A and Plan B)
  • Maintains professional relationship with payer representatives and assists in resolving any utilization issues that arise. Promotes a smooth transfer of information between payer representatives, community providers and healthcare team
  • Ensures communication to the family and interdisciplinary team via patient/family conferences and complete documentation
  • Assures timely progression occurs to appropriate levels of care
  • Collects, analyzes and interprets clinical / fiscal processes and outcomes for purposes of patient safety, optimum utilization management, and system and process improvements
  • Regularly evaluates self practice/performance and sets goals for personal and professional development
  • Facilitates physician to physician communication when applicable


Qualifications:

  • Associate’s Degree in Nursing or Technical Diploma in Nursing
  • Bachelor’s Degree in Nursing preferred
  • RN - Lic-Registered Nurses from state of Texas
  • CCM - Cert-Certified Case Manager preferred
  • 3 years in position requiring RN licensure in an acute care setting
  • Pediatric and case/care management experience preferred


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