Case Management is a collaborative practice that assesses, plans, implements, coordinates, monitors, and evaluates the options and services required to meet the member’s health and human service’s needs
Job Summary
Case Management is a collaborative practice that assesses, plans, implements, coordinates, monitors, and evaluates the options and services required to meet the member’s health and human service’s needs.
The Case Manager facilitates clinically appropriate and fiscally responsible patient care through communication with the treating physicians, and all other members of the health care team.
The Case Management Process is centered on a client/support system and is holistic in its coverage of the client’s situation and addresses medical, physical, emotional, financial, psychosocial, behavioral, emotional, and other needs.
Matching Summary
Case Management is a collaborative practice that assesses, plans, implements, coordinates, monitors, and evaluates the options and services required to meet the member’s health and human service’s needs.
Skills & Requirements
Must-have
Medicaid criteria/guidelines knowledge
Managed care contracts/guidelines knowledge
Data-driven decision-making tools
Reimbursement mechanisms knowledge
Member needs assessment
Care coordination and planning
Nice-to-have
Compassion and innovation
Employee family culture
Ethical business practices
Performance improvement activities
Key Requirements
3 years prior clinical experience
Graduate of accredited school of Nursing
Current Texas RN licensure
Acute inpatient case management experience preferred
Managed care case/utilization management experience preferred