Houston Northwest Medical Center - Houston, Texas Manager of Case Management - Utilization Review
Since 1973, Houston Northwest Medical Center
has been providing comprehensive healthcare to the North Houston communities. The hospital is known for its maternity and women's services, including a Level II Neonatal ICU, and for its cardiac care as well as bariatric and diabetes programs. In addition to its hospital emergency room, Houston Northwest Medical Center operates two urgent care centersHouston Northwest Medical Center
is currently accepting applications for Manager of Case Management - Utilization Review. Responsibilities:
Qualifications: Qualifications: Education: Experience:
- The Manager of Case Management is responsible for overseeing day-to-day operations within the Case Management department.
- Responsible for establishing appropriate staffing levels and work assignments, developing performance criteria for staff, serving as an expert resource on laws, policies and operational procedures, and ensuring that the operations of the Case Management department are consistent with facility organizational standards.
- Provides management direction to the Discharge Planners, Utilization Reviewers, and Care Coordinators in Case Management department.
- Identifies appropriate staffing levels, assignments and deployments for the department. Monitor performance criteria for staff members.
- Reviews operations of the Care Management department to ensure high level of quality is consistent with organization standards.
- Reviews department performance in relation to established goals. Implements changes to effect continual improvement in services provided
- Interprets laws, policies, operational procedures and objectives. Ensures compliance with regulatory and legal requirements.
- Shares with Director responsibility for collecting, analyzing, evaluating and presenting clinical management and operations data to a wide range of audiences.
- Assists the Director in development of a comprehensive safety/quality and performance improvement program inclusive of the analysis and trending of data related to initiatives undertaken.
- Work closely with medical staff leadership, clinical department chairs and committee chairs to ensure appropriate medical staff involvement in institutional resource management efforts.
- Participates on assigned medical staff, executive and corporate committees; promotes effective communication between departments and entities, acting as a liaison to facilitate information sharing, collaborative problem solving and adequate provision of support services; fosters and maintains collaborative relationships within the hospital and the Health System, and with external agencies related to quality and performance initiatives as well as day to day operations issues that may arise.
- Directly responsible for personnel actions including, but not limited to, hiring, performance appraisals, promotions, vacation schedules, and maintaining payroll records and time reports.
- Collaborate with administration, management and educational resources to develop mechanisms for staff development and to make appropriate changes as needed to keep department current with new regulations, policies and trends in the Case Management field.
- In collaboration with the Director, participates in the preparation of department budget. Make budgetary recommendations and projections. Monitor, verify and reconcile expenditures of budgeted funds, compiling information reflecting expenditures, and develop cost-comparisons. Identify cost savings within the operation.
- Maintain skills in case management/utilization management to allow for coverage of a caseload as needed and/or to cover staffing shortages in the department.
- Perform other related duties incidental to the work described herein.
- 5 years of relevant experience required
- Management experience preferred
- Must have current RN licensure in the state of Texas