Our client a 426-bed facility located in Houston, Texas. The hospital opened its doors in 1973 and has since become one of the most comprehensive medical facilities in the area.
Northwest has earned numerous awards and accreditations in the areas of Quality Care, Bariatric Surgery, Breast Care, and Heart and Vascular Care. Recently, the facility received an "A" grade in patient safety from The Leapfrog Group. Staff members say the facility has a strong culture of employee engagement and that their colleagues feel like family. This close-knit community of 600 medical professionals is dedicated to delivering quality patient care and ensuring patient safety.
Reports directly to the Director of Case Management and provides oversight to the Case management team.
Responsible for coordinating, monitoring, executing and evaluating Case Management Department activities.
Accountable for assisting hospital utilization performance improvement in order to promote effective utilization of hospital resources, ensure processes support appropriate reimbursement for services rendered, support efficient patient throughput, and ensure compliance with all state and federal regulations related to case management services.
Utilization Management supporting medical necessity and denial prevention
Transition Management promoting appropriate length of stay, readmission prevention and patient satisfaction
Care Coordination by demonstrating throughput efficiency while assuring care is the right sequence and at appropriate level of care
Compliance with state and federal regulatory requirements, TJC accreditation standards and HCA policy
Education provided to physicians, patients, families and caregivers
Registered Nurse with active license; BSN required.
One year acute hospital case management leadership experience preferred.
McKesson InterQual® experience preferred.
Two years acute hospital case management experience preferred.
Accredited Case Manager (ACM) preferred.
Salary Range: $36.43 (5 years experience) Mid $43.71 (5-10 years experience) Max $51 (10+ years experience)