Case Manager
Position Highlights
Experienced Case Manager for MHMD Medical Home Initiative needed!
Position will maintain an office at system services on Frostwood Drive next to Memorial City hospital, but will work primarily in 1 of 4 available regions in the Houston market: Central, West, SW, or SE.
Reports to the Director of Case Management, and works in collaboration with physicians, payors, staff, and other healthcare professionals. The case manager works to support primary care medical homes from a team approach, and in continuous partnership with families and physicians to promote: timely access to needed care, comprehension and continuity of care, and th enhancement of patient and family well being. Coordinates appropriate resources to facilitate and ensure the patients progress through the continuum of care. Actively participates in the quality review process and assures continual improvement of patient safety, clinical practice, and quality patient care. Is an integral member of the health care team who works to ensure safety, best practice and high quality standards of care are maintained across the entiure continuum of care. Responsible for coordinating a wide range of self management support and disease registry activities. Works closely with the patient care team and key collaboratives across the MHHS, hospital based case managers and community based resources.
MINIMUM QUALIFICATIONS, EDUCATION AND EXPERIENCE:
1.Current and valid license to practice as a Registered Nurse (ADN or BSN) in the state of Texas
2.Professional certification as a Case Manager required within two years of employment.
3.Three or more years clinical experience in clinical practice area to which assigned
4.Excellent interpersonal communication and negotiation skills.
5.Strong analytical, data management and PC skills.
6.Current working knowledge of disease or population management, utilization management, case management, performance improvement and managed care reimbursement.
7.Understanding of physician office routines, community resources, transitional procedures for pre and post-acute care.
8.Strong understanding of motivational interviewing and change management.
9.Strong organizational and time management skills, as evidenced by capacity to prioritize multiple tasks and role components.
10. Ability to work independently, and excercise sound judgement in interactions with physicians, payors, patients and their families.
PRINCIPAL ACCOUNTABILITIES:
1.Demonstrate and apply knowledge of the philosphy/principles of comprehensive, community based, family-centered, developmentally appropriate, culturally sensitive care coordination services.
2.Facilitate patient, and family access to medical home providers, staff and resources.
3.Assist or promote the identification of patients in practices with special health care needs or patients at high risk; add to registry and use to plan and monitor care.
4.Assess patient and family contacts, create ongoing processes for patients and families to receive the desired level of care coordination support they request.
5.Develop care plan with patient, family, and health care team.
6.Serve as a contact point, advocate and informational resource for physicians, patient, family, and community partners/payers.
7.Research, find and link resources, services and support with/for patient and family.
8.Coordinate inter-organizationally among patient, family, medical home, and involved agencies;offer outreach to the community.
9.Cultivate and support primary care and specialty co-management with timely communication, inquiry, follow up and integration of information into the care plan.
10.Serve as a medical home quality improvement team member.
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