What are the responsibilities and job description for the Nurse Manager - Case Management position at UVALDE MEMORIAL HOSPITAL?
Uvalde Memorial Hospital is seeking an experienced and dedicated Manager of Case Management to lead our case management department. This key leadership position ensures effective patient care coordination, regulatory compliance, and financial stewardship through strategic utilization review and case management practices.
Primary Responsibilities:
Leadership: Guide and manage a team of skilled case management and utilization review professionals, fostering alignment with organizational standards and best practices.
Utilization Review Oversight: Develop and implement compliance-focused utilization review protocols to optimize resource utilization and enhance patient outcomes.
Case Management: Oversee patient care coordination, emphasizing efficient discharge planning and smooth care transitions in collaboration with interdisciplinary healthcare teams.
Financial & Regulatory Management: Ensure adherence to regulatory standards and oversee claims management, appeals, and denial processes to maximize reimbursement.
Data & Reporting: Monitor and analyze key metrics, preparing performance and quality reports for senior leadership to drive improvement initiatives.
Communication & Collaboration: Serve as a liaison between clinical staff, patients, and insurance providers, ensuring clear and supportive communication throughout care transitions.
Qualifications:
- Education: Bachelor’s degree in Nursing, Healthcare Administration, or a related field required; Master’s degree preferred.
- Licensure/Certification: Active RN license in Texas; certifications in case management (e.g., CCM, ACM, CPHQ) are highly preferred.
- Experience: Minimum of 2 years in a healthcare management role, with direct experience in case management or utilization review.
- Skills: Strong leadership, communication, analytical, and regulatory expertise necessary for success in this role.
Position Details:
- This is a 100% on-site role located at Uvalde Memorial Hospital in Uvalde, Texas.
- Uvalde is a charming rural community situated 90 miles west of San Antonio, Texas. Candidates must be willing to relocate or commute. Remote work is not available for this position.
If you are a results-driven leader with a passion for case management and a commitment to excellence, we encourage you to apply.
