Top 221 Rn Case Management Jobs in Houston, TX

RN Case Manager Acute Care
River Oaks Hospital and Clinics —Houston, TX
- $70,000 - $80,000 a year
- Full-time
- Background check
- Spanish
- Nursing
- Disability insurance
- Health insurance
Quick Apply
RN Hospice Case Manager - Pasadena
Living Hope Hospice —Houston, TX
- $80,000 - $85,000 a year
- Part-time
- CPR Certification
- Nursing
- RN License
- Travel reimbursement
- Paid training
Quick Apply
2d
RN CLINICAL CASE MANAGER
Legent Health —Bellaire, TX
- Full-time
- Nursing
- Mid-level
- US work authorization
- Paid time off
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Registered Nurse Case Manager (Hospital-Based GIP Admission)
Uplift Hospice —Houston, TX
- $87,500 - $95,000 a year
- Full-time
- Nursing
- Medication administration
- RN License
- Mileage reimbursement
- Health insurance
Quick Apply
RN Case Manager- Trauma Services
Vbeyond Corporation —Houston, TX
- $108,000 - $130,000 a year
- Full-time
- Background check
- Management
- RN License
- Health insurance
- Dental insurance
Quick Apply
22h
Case Manager-Registered Nurse (RN)-PRN
Houston Methodist Hospital —Houston, TX
- PRN
- Acute care
- Nursing
- Microsoft Excel
FT - RN Field Case Manager - WE'RE GROWING! South of I-10
Houston Hospice —Houston, TX
- Full-time
- Nursing
- RN License
- BLS Certification
Quick Apply
FT - RN Field Case Manager - Jersey Village
Houston Hospice —Houston, TX
- Full-time
- Nursing
- RN License
- BLS Certification
Quick Apply
Case Manager-Registered Nurse (RN)
Houston Methodist Hospital —Houston, TX
- Full-time
- Acute care
- Nursing
- Microsoft Excel
11d
Case Manager (RN)
Houston Methodist Baytown Hospital —Baytown, TX
- Full-time
- Acute care
- Nursing
- Microsoft Excel
7d
Registered Nurse/ RN, Home Health $15,000 Bonus
AccentCare, Inc. —Houston, TX
- $83,000 - $102,000 a year
- Full-time
- CPR Certification
- Nursing
- Management
- Health savings account
- Paid holidays
Quick Apply
Manager Case Management & Social Services RN
Houston Methodist Willowbrook Hospital —Houston, TX
- Full-time
- Acute care
- Nursing
- RN License
10d
Case Manager - RN
Houston Methodist Willowbrook Hospital —Houston, TX
- Full-time
- Nursing
- Microsoft Excel
- Microsoft Outlook
16h
Case Manager / RN (PRN)
Houston Methodist Willowbrook Hospital —Houston, TX
- PRN
- Nursing
- Microsoft Excel
- Microsoft Outlook
Registered Nurse (RN) - Case Management
Angels of Care Pediatric Home Health —Pearland, TX
- Full-time
- Nursing
- RN License
- Mid-level
- Health savings account
- Health insurance
Quick Apply
Case Manager
Houston Methodist Sugar Land Hospital —Sugar Land, TX
- Full-time
- Acute care
- Nursing
- Microsoft Excel
4d
Case Manager
Houston Methodist Sugar Land Hospital —Sugar Land, TX
- Full-time
- Acute care
- Nursing
- Microsoft Excel
4d
RN - Case Manager
Vibra Travels LLC —Houston, TX
- $2,646 a week
- Online Application
- Nursing
- RN License
- BLS Certification
- Referral program
Quick Apply
3d
Field Care Manager, LTSS (RN) - Local Travel Required
Molina Healthcare —Channelview, TX
- $26.41 - $51.49 an hour
- Full-time
- Microsoft Excel
- Microsoft Outlook
- RN License
- Health insurance
UTILIZATION REVIEW NURSE - RN
Nexus Health Systems Ltd —Houston, TX
- Full-time
- Nursing
- Microsoft Excel
- Microsoft Outlook
Quick Apply

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Rn Case Management jobs near Houston, TX

RN Case Manager Acute Care

River Oaks Hospital and Clinics
Houston, TX

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Job Details

Full-time
$70,000 - $80,000 a year

Benefits

Disability insurance
Health insurance
Dental insurance
401(k)
Paid time off
Employee assistance program
Vision insurance
Life insurance

Qualifications

Spanish
RN License
Intake
Patient assessment
BLS Certification
Microsoft Office
Managing patients as a nurse case manager
Driver's License
Medical records
Case management
Patient care
Discharge planning

Full Job Description

SUMMARY

This position works closely with the interdisciplinary team to facilitate and maintain compassionate, safe and efficient quality care and achieve desired treatment outcomes. This position works closely with the team to ensure effective discharge planning and continuity of care; and communicates clinical information to payers to ensure reimbursement.

Job Duties and Responsibilities
1. Collaborates with the physician and team to facilitate care, monitor the patient’s progress, intervening as needed to ensure high quality, efficient, and cost-effective services to the patient that are timely.

2. Educates staff and serves as a resource for meeting needs of the patient and facility.

3. Performs review for medical necessity of admission, continued stay and resource use, appropriate level of care and program compliance.

3.1 Identifies when services no longer meet criteria, initiates discussion with physicians, coordinates with the external case manager to facilitate discharge planning, seeks assistance from physician advisor when needed, and informs management of possible need for issuing Medicare Hospital Initiated Notice of Non-coverage.

3.2 Applies approved utilization criteria to monitor appropriateness of admissions, level of care, resource utilization, and continued stay.

3.3 Reviews level of care denials to identify trends and collaborates with team to recommend opportunities for process improvement.

4. Plans for routine / difficult discharge and anticipates / prevents and manages emergent situations. Specific focus is given to discharge plan and elimination of barriers.

5. Performs post-discharge review by analyzing the medical record to ensure that compliance with quality indicators is met. Communicates reports to appropriate leader regarding regulatory concerns.

6. Monitors length of stay (LOS) on an ongoing basis. Proactively takes action to expedite care / facilitate discharge.

6.1 Manages all patients in observation status, daily, informing physicians of timely disposition options to assure maximum benefits for patients and reimbursement for the hospital.

6.2 Secures reimbursement for hospital services by communicating medical information required by all external review entities, managed care contracts, insurers, fiscal intermediaries, and state / federal agencies.

6.3 Responds to requests for information, monitors covered days, initiates review to assure that all days are covered and reimbursable.

7. Supports and follows the mission, vision, values and policies of the hospital and communicates with the appropriate leadership and staff.

Qualifications (Education, Experience and Certifications)

Education: RN graduate from an accredited nursing program. Master’s Degree preferred.

Certification, Licensure: Current license as a registered nurse in the state of Texas; current American Heart Association BLS certification.

Experience, Training, Knowledge: Three (3) years hospital clinical experience; two (2) years case manager experience.

KNOWLEDGE, Skills And Abilities
Strong assessment, organizational and problem solving skills

Knowledge of Medicare, Medicaid and managed care requirements.

Comprehensive knowledge of community resources, healthcare financial and payer requirements and eligibility requirements for county, state and federal programs.

Adept at computer operating skills, including Microsoft Office.

Job Type: Full-time

Pay: $70,000.00 - $80,000.00 per year

Benefits:

401(k)
Dental insurance
Disability insurance
Employee assistance program
Health insurance
Life insurance
Paid time off
Vision insurance

Medical Specialty:

Primary Care

Language:

Spanish (Required)

Ability to Commute:

Houston, TX 77027 (Required)

Ability to Relocate:

Houston, TX 77027: Relocate before starting work (Preferred)

Work Location: In person

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Refine Your Search

Rn Case Management jobs in Houston, TX

RN Case Manager Acute Care

RN Hospice Case Manager - Pasadena

RN CLINICAL CASE MANAGER

Registered Nurse Case Manager (Hospital-Based GIP Admission)

RN Case Manager- Trauma Services

Case Manager-Registered Nurse (RN)-PRN

FT - RN Field Case Manager - WE'RE GROWING! South of I-10

FT - RN Field Case Manager - Jersey Village

Case Manager-Registered Nurse (RN)

Case Manager (RN)

Registered Nurse/ RN, Home Health $15,000 Bonus

Manager Case Management & Social Services RN

Case Manager - RN

Case Manager / RN (PRN)

Registered Nurse (RN) - Case Management

Case Manager

Case Manager

RN - Case Manager

Field Care Manager, LTSS (RN) - Local Travel Required

UTILIZATION REVIEW NURSE - RN

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