staff - Registered Nurse (RN) - Case Management - $45+ per hour

Job Overview Memorial Hermann Health System is seeking a Registered Nurse (RN) Case Manager in Sugar Land, Texas. The position is a staff role, ongoing, 36 hours per week with a 12-hour day/night shift schedule. Job Summary The Case Manager supports physicians, primary medical homes, and interdisciplinary teams to facilitate patient care, with the goal of improving clinical outcomes and patient satisfaction while managing care costs. Responsibilities Coordinate and facilitate patient care across the continuum, collaborating with physicians, nursing and other multidisciplinary team members. Identify and resolve system problems that impede diagnostic or treatment progress, proactively addressing delays to discharge. Develop and implement patient‑specific care and discharge plans, ensuring timely completion of diagnostic testing and treatment plans. Communicate effectively with payors, third‑party providers, and the Resource Center to secure reimbursement and resolve issues. Collect, analyze, and report financial and quality indicators such as LOS, cost per case, readmission rates, and denial metrics. Lead or participate in clinical performance improvement activities and clinical pathway development. Act as preceptor and mentor to new hires, assisting with orientation and ongoing training. Perform utilization management and quality screening, applying clinical appropriateness criteria to admissions and ongoing stays. Maintain documentation in TQ screens and patient records, ensuring accuracy and completeness. Communicate critical elements of the care plan to patients, families, and the healthcare team to ensure continuity of care. Qualifications Graduate of an accredited school of professional nursing required; bachelor’s degree preferred, or graduate of an accredited Master of Social Work program (MSW); master’s degree preferred. Current and valid RN license in Texas, or current and valid LMSW license in Texas (LCSW preferred). Certification in Case Management required within two years of hire. Minimum three years of hospital‑based nursing or social work experience. Experience in utilization management, case management, or discharge planning preferred. Strong interpersonal communication, negotiation, and leadership skills. Proficient in analytical, data management, and PC skills. Working knowledge of discharge planning, utilization management, performance improvement, and managed care reimbursement. Knowledge of pre‑acute and post‑acute venues, community resources, and transitional procedures. Understanding of motivational interviewing and change management. Excellent organizational and time‑management skills, with the ability to prioritize multiple tasks. Capacity to work independently and exercise sound judgment with physicians, payors, and patients. Effective oral and written communication skills. Benefits Dental benefits Vision benefits Employee assistance programs 403b retirement plan Health Care FSA Dependent Care FSA School loan reimbursement #J-18808-Ljbffr Memorial Hermann Health System