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Cook Children's Health Care System

Case Manager (Nex)

Fort Worth, TX

Location:
Medical Center - Fort Worth

Department:
Case Management

Shift:
First Shift (United States of America)

Standard Weekly Hours:
40

Summary:

The RN Case Manager (Nex) uses a collaborative process to plan, assess, implement, monitor and evaluate the options and services required to meet the healthcare needs of the patients using the functions of Utilization Review using Interqual and Milliman Care Guidelines, Discharge Planning and Case Management in order to facilitate: (1) quality of patient care; (2) cost effective utilization and outcome management; (3) communication between patients, families, and members of the health care team; (4) expedition of the movement of patients through appropriate levels of care; and (5) information gathering for Quality & Risk Management utilizing Joint Commission Accreditation of Healthcare standards and clinical indicators. The Case Manager will assist with the identification of appropriate providers and facilities throughout the continuum of care, to ensure that resources of both CCMC and the patient are used in a timely and cost-effective manner to meet the healthcare needs of the patient.

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Education and Experience

Associate degree in nursing and at least three years of any combination of experiences working in/with case management, care coordination, utilization review, patient intake, discharge planning and troubleshooting fund resources, quality assurance, clinical pathways, continuous quality improvement, or state and federal health plans or commercial insurance plans in a clinical or managed care environment.

  • Must be computer literate, and have effective organizational, interpersonal, written, and oral communication skills.
  • Must be familiar with various community resources and charitable organizations.
  • Must be able to adapt to changing healthcare environments and work with all members of the healthcare team to achieve positive outcomes.
  • Must have experience using or navigating electronic medical records (e.g., EPIC, Meditech, Healthy Planet, etc.).
  • BSN from an accredited college or university is preferred.
  • Bilingualism is preferred or may be required depending on the specific department assignment.

Licensure, Registration, and/or Certification

  • Current RN license from Texas Board of Nursing required
  • Must achieve a Basic Life Support (BLS) certification for Health Care Providers within 30 days of employment and must maintain this certification as per Medical Center Policy, MC 175.

This requirement does not apply to Health Plan

  • Case Manager Certification (CCM) preferred.

About Us:

Cook Children's Medical Center is the cornerstone of Cook Children's, and offers advanced technologies, research and treatments, surgery, rehabilitation and ancillary services all designed to meet children's needs.

Cook Children's is an EOE/AA, Minority/Female/Disability/Veteran employer.

Client-provided location(s): Fort Worth, TX, USA
Job ID: Cook_Childrens-JR-108957
Employment Type: Part Time

Perks and Benefits

  • Health and Wellness

    • Health Insurance
    • Health Reimbursement Account
    • Dental Insurance
    • Vision Insurance
    • Life Insurance
    • Short-Term Disability
    • Long-Term Disability
    • FSA
    • FSA With Employer Contribution
    • HSA
    • HSA With Employer Contribution
    • Fitness Subsidies
    • On-Site Gym
    • Pet Insurance
    • Mental Health Benefits
  • Parental Benefits

    • Birth Parent or Maternity Leave
    • Adoption Assistance Program
    • Family Support Resources
    • On-site/Nearby Childcare
    • Adoption Leave
    • Fertility Benefits
    • Non-Birth Parent or Paternity Leave
  • Work Flexibility

    • Hybrid Work Opportunities
  • Office Life and Perks

    • Company Outings
    • On-Site Cafeteria
    • Holiday Events
  • Vacation and Time Off

    • Paid Vacation
    • Paid Holidays
    • Personal/Sick Days
    • Leave of Absence
  • Financial and Retirement

    • Performance Bonus
    • Relocation Assistance
    • Financial Counseling
    • 401(K) With Company Matching
  • Professional Development

    • Tuition Reimbursement
    • Promote From Within
    • Access to Online Courses
    • Lunch and Learns
    • Leadership Training Program
    • Professional Coaching
  • Diversity and Inclusion

    • Diversity, Equity, and Inclusion Program
    • Employee Resource Groups (ERG)