Care Manager
Company: Texas Childrens Hospital
Location: The Woodlands , TX
Category: Management, Healthcare
Job Type: Full Time
Posted: 7/11/2018
JOB DESCRIPTION:

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.

 

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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
JOB REQUIREMENTS:

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
ADDRESS:
The Woodlands , TX
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