RN Case Manager Concurrent Review
Location: Pearland Administrative Office
Department: KS Plan Advantage Population Health
Job Type: Full Time
Kelsey-Seybold Clinic. Changing the way health cares.
Kelsey-Seybold Clinic is Houston’s premier multispecialty group practice, founded in 1949 by Dr. Mavis Kelsey. With more than 21 clinic locations and more than 400 physicians, Kelsey-Seybold provides medical care in 55 medical specialties and is home to a nationally accredited Breast Diagnostic Center, Endoscopy Center, Infusion Center and Cancer Center. Our mission is to provide our team members with exceptional opportunities for professional and personal growth.
The Concurrent Review Case Manager is responsible for telephonic monitoring and the documentation of medical treatment and comparing it to established criteria to determine if treatment meets established guidelines. In addition, the Concurrent Review Case Manager monitors patients progress toward recovery for early identification of continuing care needs in an attempt to facilitate discharge for specified populations. This position works closely with Medical Management Physician leadership and various internal departments.
EDUCATION REQUIREMENTS & EXPERIENCE REQUIREMENTS
(A = basics; B = preferred)
Registered Nurse, ADN or master’s degree in Social Work
Certification in area of specialization, BSN
Five years nursing experience or three years’ experience in medical social work with an emphasis in case management of high risk patient population
Proven program development skills
TX RN license or TX LCSW license, valid Texas Driver’s license
Case Management Certification
Proven communication and problem-solving skills; Computer literate
At least 2 years in area of specialization, 2 years of Case Management/Utilization Review experience
Managed Care knowledge