Job Description

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.

Responsibilities

The working Manager of Case Management is responsible for the development of staff and systems to effectively operate a comprehensive Case Management Program. Provides leadership and supervision to case managers, social workers, case management coordinators/discharge planners, utilization review coordinators and utilization review technicians. Assesses needs and plans, communicates and designs services that are appropriate to the hospital mission and patient/family needs. Integrates and coordinates services using continuous quality improvement tools. 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. 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.

Qualifications

EDUCATION, EXPERIENCE, TRAINING

Required qualifications:

1. Licensed clinician in your state or;

2. Grandfathered prior to April 1, 2015. Minimum 5 years’ post graduate of an accredited school of Social Work for Licensed Clinical Social Worker.

3. Minimum 5 years’ experience in a Case Management position.

4. Must have analytical ability for problem identification and assessment and evaluation of data/statistics obtained from an on-going review process.

5. Experience and knowledge in basic to intermediate computer skills.

Preferred qualifications:

1. CCM or obtained within 1 year 2. BS or BSN or related field preferred.3. Current BCLS certificate preferred.4. Knowledge of Milliman Criteria and InterQual Criteria preferred.

Employment Status

Full Time

Shift

Days

Equal Employment Opportunity

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