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Job: Manager (RN) - Case Management

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Job Description


Reports to Administrative Director of Case Management and is responsible for assisting the Director with planning, organizing and directing Hospital Social Work and Case Management programs in accordance with the federal, state and local regulations.  Determines scope and emphasis of the programs, and maintains cooperative working relationships with other hospital departments and outside agencies in order to coordinate provision of health and medical care services.  Guides program of staff development and ensures staff awareness of available community resources.



1.      Consistently supports and communicates the Mission, Vision and Values of St. Joseph Medical Center.


2.      Follows St. Joseph Medical Center Guidelines related to the Health Insurance Portability and Accountability Act (HIPAA), designed to prevent or detect unauthorized disclosure of Protected Health Information (PHI)


3.      Promotes a culture of safety for patients and associates through proper identification, proper reporting, documentation and prevention of medical errors in a non-punitive environment.


4.       Provides professional and administrative direction necessary to ensure effective and efficient delivery of services.  Ensures compliance with all regulatory agency requirements.


5.      Plans, develops and implements short and long range goals and objectives consistent with hospital goals and objectives.


6.      Develops and maintains cooperative working relationships with various hospitals departmental and outside agency personnel in order to coordinate department functions with other patient services.


7.      Interviews, hires, orientates, trains, evaluates the performance of and, when necessary, disciplines   personnel.


8.       Prepares regular and special reports and analyses indicating departmental activity and needs of patients

serviced in order to ascertain extent to which departmental goals are being achieved.


9.   Assist with conducting staff meeting, provide and recommend alternate methods and referral sources to provide patients with needed services.


10.  Represents Hospital and designed departments at committee, professional or community organization meetings in order to assist in developing new programs and policies for improved delivery of services.


11.  Provides guidance and assistance with more complex cases.


12.  Maintains knowledge of current trends and developments in the field by reading appropriate books, journals, other literature and attending related seminars and conferences.             


13.  Assist with reviews of financial reports for Medicare, Medicaid and Managed Care patients.  Identifies problem DRGĀ“s, and departments that are encountering utilization problems and makes recommendations to resolve identified problems.


14.  Discusses when necessary and offers solutions when possible to resolve with patients and/or family any grievances with the hospital in order to eliminate or diminish potential liability claims.


15.  Assures that all JCAHO and to other regulatory agency requirements are met.


16.  Ensures that Case Managers track re-admission rate of patients discharged and reasons.


17.  Ensures that Case Managers identify High Risk patients, and progressive chronic illness.


18.  Supportive of the compliance program set forth by SJMC and demonstrated by:

a.       Upholds the Code of Ethics and Corporate Compliance.

b.      Adheres to and helps to enforce all compliance policies relevant to his/her area.

c.       Assures timely compliance education as requested by the Compliance Officer and/or        

through corporate initiatives.


19.  Sets an example to all staff in their daily activities.


Work Experience:


Five years preferably in a hospital or healthcare setting progressively more responsible related work experience, with two years concurrent management experience. 




Licensed in the State of Texas as a Registered Nurse.


Education & Training:


Level of knowledge normally acquired through the completion of a Bachelors Degree in Nursing, Business, or related field preferred.





Technical, critical, and interpersonal skills necessary for effective leadership of assigned personnel and in order to represent department to all levels of Hospital personnel and a variety of community agencies when coordinating patient care.  Analytical skills necessary in order to develop departmental policies and procedures, prepare and administer budgets, evaluate quality of services provided and so forth.



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