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Health Management, Case Manager II
Memorial Hermann Health System. Provide care management services and support to an assigned population to improve health outcomes .
About the role
Key responsibilities & impact- Provide care management services and support to an assigned population to improve health outcomes
- Collaborate with patients, family members, clinics, hospitals, post-acute partners, insurance companies, and community resources
- Identify patients or members at risk for poor outcomes using a defined process
- Establish care plans and goals and coordinate care throughout the continuum
- Provide primary care management interventions to identified members
- Identify members needing intensive follow-up and care coordination
- Coordinate comprehensive plans of care for high-risk, high-utilizing populations
- Conduct proactive outreach through telephone, internet, and face-to-face encounters
- Address financial, psychological, and system-of-care barriers
- Facilitate relationships with post-acute providers, physicians, and community resources
- Manage transitions of care, warm hand-offs, and closure of care gaps
- Promote timely access, appropriate care utilization, adherence, primary care use, self-management, and shared decision-making
- Provide education to improve comprehension, health literacy, chronic disease self-management, and medication management
- Review medications and recommend changes to primary care providers based on evidence-based protocols
- Connect patients with relevant community resources
- Coordinate warm hand-off to primary care providers upon program completion
- Help develop and implement member care policies and protocols
- Make referrals to other Health Management team members
- Ensure safe care and comply with Memorial Hermann policies, procedures, standards, budget, productivity, and quality requirements
- Meet mandatory education and competency requirements and support department goals
- Serve as a preceptor, mentor, and resource to less experienced staff
- Model Memorial Hermann’s service standards and perform other duties as assigned
Requirements
What you’ll need- Registered Nurse (RN) or Social Worker (LMSW)
- Registered Nurse (RN), Licensed Master Social Worker (LMSW), or Licensed Clinical Social Worker (LCSW) with active license in the state of Texas
- At least two (2) years of experience in care coordination and planning or another related area
- Experience in care/case management, chronic disease management, or population health preferred
- Experience working in interdisciplinary teams
- Excellent computer skills
- Effective oral and written communication skills
- Ability to work in a fast-paced, high-touch patient care program
- Strong customer service and collaboration skills
- Ability to actively engage patients in positive relationships
Benefits
Comp & perks- Hybrid work arrangement alternating between onsite and remote work
- Mandatory/continuing education and skills competency support
- Professional growth and development opportunities
- Preceptor, mentor, and resource opportunities