Case Manager Job at PrismHR, Dallas, TX

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  • PrismHR
  • Dallas, TX

Job Description

The Case Manager facilitates effective patient care coordination, ensures appropriate resource utilization, and guides patients and families through the healthcare continuum. This full-time, on-site role focuses on improving patient outcomes, expediting care transitions, and ensuring compliance with regulatory and payer requirements.

Essential Duties:

  • 🏥 Manage patient cases from admission through discharge.
  • 🤝 Collaborate with healthcare providers to plan and coordinate care.
  • 🏠 Facilitate discharge planning and placement.
  • 📋 Evaluate medical necessity for admissions and continued stays.
  • 📝 Ensure documentation supports medical necessity and discharge planning.
  • 🗓️ Coordinate care team meetings and family conferences.
  • 📚 Educate patients and families on post-discharge care needs.
  • 📈 Participate in quality improvement initiatives.
  • 📜 Maintain knowledge of CMS regulations, payer guidelines, and hospital policies.

Behavioral Standards:

  • 👔 Follow dress code and ethical guidelines.
  • ⏰ Respect customers' and co-workers' time.
  • 📞 Utilize scripting for consistent customer service.
  • ⚡ Respond quickly to requests and complaints.
  • 📝 Attend staff meetings and follow HIPAA guidelines.
  • 🤝 Partner effectively with interdisciplinary teams.

Education & Experience:

  • 🎓 3-5 years of hospital case management or utilization review experience required.
  • 🏥 Acute care or ICU case management experience preferred.
  • 🩺 RN or LCSW in Texas required.
  • 📜 Bachelor's degree in Nursing or Social Work required; BSN/MSW preferred.
  • 🏅 Case Management Certification (ACM or CCM) preferred or obtained within 1 year of hire.

Job Tags

Full time,

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