What are the responsibilities and job description for the Case Manager - Utilization Management position at Harlingen Medical Center?
| Location | US-TX-Harlingen | ID | 2025-198083 | Category | Clinical Professional | Position Type | Full Time | Shift | Days | Job Type | Non-Exempt |
Join an award-winning team of dedicated professionals committed to our core values of quality, compassion and community! Harlingen Medical Center, a member of Prime Healthcare, offers incredible opportunities to expand your horizons and be part of a community dedicated to making a difference.
Harlingen Medical Center is a Level IV Trauma Designated hospital that specializes in Cardiovascular Service, Emergency Services, Neuroscience, Orthopedic Services, Radiology, Rehabilitation Services and Surgical Services. Harlingen Medical Center has provided high-quality "Patient Focused Care" to the residents of Western Cameron County for more than 15 years. Harlingen Medical Center, one of South Texas's best kept secrets, offers patients the best of both worlds--a warm, caring environment, close to home while providing the wide range of services and expertise typically found in much larger facilities.
Company is an equal employment opportunity employer. Company prohibits discrimination against any applicant or employee based on race, color, sex, sexual orientation, gender identity, religion, national origin, age (subject to applicable law), disability, military status, genetic information or any other basis protected by applicable federal, state, or local laws. The Company also prohibits harassment of applicants or employees based on any of these protected categories. Know Your Rights: https://www.eeoc.gov/sites/default/files/2022-10/EEOC_KnowYourRights_screen_reader_10_20.pdf
Responsible for the quality and resource management of all patients that are admitted to the facility from the point of their admission and across the continuum of the health care management. Works on behalf of the advocate, promoting cost containment and demonstrates leadership to integrate the health care providers to achieve a perceived seamless delivery of care. The methodology is designed to facilitate and insure the achievement of quality, clinical and cost effective outcomes and to perform a holistic and comprehensive admission and concurrent review of the medical record for the medical necessity, intensity of service and severity of illness.
Education and Work Experience
- Grandfathered prior to April 1, 2015. Minimum 5 years post graduate of an accredited school Of Social Work for Licensed Clinical Social Worker. However, RN Case Manager preferred.
- Five years acute care nursing experience preferred. At least one year experience in case management, discharge planning or nursing management, preferred.
- Current BCLS (AHA) certificate upon hire and maintain current;
- Knowledge of Milliman Criteria and InterQual Criteria preferred.
- Experience and knowledge in basic to intermediate computer skills.
- Behavioral Violence Prevention Training within 3 months of hires and maintain current.
We are an Equal Opportunity/ Affirmative Action Employer and do not discriminate against applicants due to veteran status, disability, race, sexual orientation, gender, gender identity, or other protected characteristics. If you need special accommodation for the application process, please contact Human Resources:
hr-prime@primehealthcare.com
