Case Manager - TX - On Site
About us
We are a community-based hospital located near the historic White Rock Lake community, that serves the Dallas, Garland, Mesquite and surrounding areas. We specialize in a wide range of services including comprehensive medical/surgical care, bariatric, cardiology, outpatient and emergency medicine.
Our mission is to deliver exceptional healthcare with compassion and excellence. We are seeking compassionate, care-minded individuals to join our company and make a difference. As a member of the White Rock Medical Center team, you can advance your skills while working in a supportive and patient-focused environment.
Position Summary
The Case Manager is responsible for facilitating effective and efficient patient care coordination, ensuring appropriate resource utilization, and guiding patients and families through the healthcare continuum. This is a full-time, on-site position focused on improving patient outcomes, expediting care transitions, and ensuring compliance with regulatory and payer requirements.
Essential Duties and Responsibilities
- Manages patient cases from admission through discharge for inpatient, observation, and ICU populations.
- Collaborates with physicians, nurses, social workers, and other healthcare providers to plan and coordinate patient care.
- Facilitates timely and appropriate discharge planning and placement to ensure continuity of care.
- Evaluates medical necessity for admissions and continued stays in accordance with clinical guidelines and payer requirements.
- Ensures documentation supports medical necessity, level of care, and discharge planning efforts.
- Coordinates care team meetings and family conferences as needed.
- Provides education to patients and families on post-discharge care needs and available resources.
- Participates in quality improvement initiatives related to length of stay, readmissions, and patient outcomes.
- Maintains current knowledge of CMS regulations, payer guidelines, and hospital policies.
Knowledge, Skills, and Abil ities
Behavioral Standards
- Wears nametag properly; follows dress code policy; answers phone correctly and promptly; is prepared for meetings; meets deadlines; does not participate in gossip; acts ethically and treats others with respect.
- Respects customer's and co-worker's time; establishes and maintains effective relationships with customers and co-workers.
Communication/Knowledge
- Treats everyone as their customer; utilizes scripting and other tools to ensure consistency in customer service.
- Expresses recognition and shows appreciation to others.
- Fully utilizes AIDET principles.
- Responds quickly to handle requests, complaints and questions; displays a positive attitude.
Collaboration/Teamwork
- Attends staff meetings; follows HIPAA guidelines and patient rights policy.
- Demonstrates knowledge of role in a disaster and emergency codes.
- Follows standard precautions and supports the safe management of the care environment.
- Partners effectively with interdisciplinary teams to meet patient and organizational goals.
Education & Experience
- Minimum of 3-5 years of hospital case management, discharge planning, or utilization review experience required.
- Experience in acute care or ICU case management highly preferred.
- Registered Nurse (RN) or Licensed Clinical Social Worker (LCSW) in the State of Texas required.
- Bachelor's degree in Nursing or Social Work required; BSN/MSW preferred.
- Case Management Certification (ACM or CCM) strongly preferred or obtained within 1 year of hire.