Case Manager - RN

Houston Methodist Willowbrook Hospital / Full-Time; Evening Shift

At Houston Methodist, the Case Manager (CM) position is a registered nurse (RN) responsible for comprehensively planning for case management, which includes care transitions and discharge planning of a targeted patient population on a designated unit(s) and/or service lines. This position works with the physicians and interprofessional health care team to facilitate and maintain compassionate, efficient, quality care and achievement of desired treatment outcomes. The CM position holds joint accountability with the social worker for discharge planning and continuity of care and assures that admission and continued stay are medically necessary, communicating clinical information to payors to ensure reimbursement.

FLSA STATUS

Exempt

QUALIFICATIONS

EDUCATION

• Graduate of education program approved by the credentialing body for the required credential(s) indicated below in the Certifications, Licenses and Registrations section.
• Bachelor's degree preferred

EXPERIENCE

• Three years hospital nursing clinical experience
• Case management experience preferred

LICENSES AND CERTIFICATIONS

Required

• RN - Registered Nurse - Texas State Licensure - Texas Board of Nursing_PSV Compact Licensure - Must obtain permanent Texas license within 60 days (if establishing Texas residency)

SKILLS AND ABILITIES

• Demonstrates the skills and competencies necessary to safely perform the assigned job, determined through on-going skills, competency assessments, and performance evaluations
• Sufficient proficiency in speaking, reading, and writing the English language necessary to perform the essential functions of this job, especially with regard to activities impacting patient or employee safety or security
• Ability to effectively communicate with patients, physicians, family members and co-workers in a manner consistent with a customer service focus and application of positive language principles
• Knowledge of Medicare, Medicaid and Managed Care requirements
• Progressive knowledge of community resources, health care financial and payor requirements/issues, and eligibility for state, local and federal programs
• Progressive knowledge of discharge planning, utilization management, case management, performance improvement and managed care reimbursement
• Understanding of pre-acute and post-acute venues of care and post-acute community resources
• Ability to work independently and exercise sound judgment in interactions with physicians, payors, and patients and their families
• Well versed in computer skills of the entire Microsoft Office Suite (Excel, Outlook, PowerPoint and Word)
• Strong assessment, organizational and problem-solving skill

ESSENTIAL FUNCTIONS

PEOPLE ESSENTIAL FUNCTIONS

• Communicates in an active, positive and effective manner to all health care team members and reports pertinent patient care and family data in a comprehensive and unbiased manner; listens and responds to the ideas of others.
• Collaborates with staff from the interprofessional health care team concerning safety data to improve outcomes and the safe transition of care. Uses a structured format for regular communication with patients and families.
• Contributes towards improvement of department scores for employee engagement, i.e. peer-to-peer accountability.

SERVICE ESSENTIAL FUNCTIONS

• Assesses all patients timely and thoroughly. Participates in daily Care Coordination Rounds (CCR), and identifies, communicates barriers to efficient patient throughput. Supports patients and families in preventing/resolving clinical or ethical issues.
• Facilitates discharge planning activities for assigned patients and collaborates with the social worker and other members of the interprofessional health care team, as well as patient and family, on complex discharges. Maintains ownership of the discharge planning process on assigned units.
• Initiates and facilitates referrals for home health care, hospice, and durable medical equipment. Consults with Social Worker Case Manager to assess psychosocial needs associated with transition to alternative levels of care, ensuring discharge disposition is to the appropriate level. Facilitates transfers.

QUALITY/SAFETY ESSENTIAL FUNCTIONS

• Modifies care based on continuous evaluation of the patient's condition, demonstrates clinical problem-solving and critical thinking, and makes decisions using evidence-based analytical approach. Documents accurate assessment and interventions efficiently and effectively.
• Plans for routine discharge and elevates emergent situations. Manages usual patient assignment and other unit demands and anticipates/plans for potential problems.
• Focuses on discharge domain by contributing to department and hospital targets for quality, patient satisfaction and safety measures.

FINANCE ESSENTIAL FUNCTIONS

• Performs review for medical necessity of admission, continued stay and resource use, appropriate level of care and program compliance using nationally recognized screening guidelines. Manages assigned patients in Observation Status, daily, informing physicians of timely disposition options to assure maximum benefits for patients and reimbursement for the hospital.
• Applies approved utilization criteria to monitor appropriateness of admissions, level of care, resource utilization, and continued stay.
• Participates in denial mitigation activities to ensure appropriate reimbursement for services rendered.
• Contributes to meeting department and hospital financial target, with focus on length of stay. Utilizes resources with cost effectiveness and value creation in mind. Self-motivated to independently manage time effectively and prioritize daily tasks, assisting coworkers as needed.

GROWTH/INNOVATION ESSENTIAL FUNCTIONS

• Identifies areas for improvement based on understanding of evidence-based practice literature. Initiates evidence-based practice/performance improvement projects based on these observations and offers solutions by participating in unit projects and activities.
• Seeks opportunities to identify self-development needs and takes appropriate action. Ensures own career discussions occur with appropriate management. Completes and updates the My Development Plan on an on-going basis.

SUPPLEMENTAL REQUIREMENTS

WORK ATTIRE

• Uniform: No
• Scrubs: No
• Business professional: Yes
• Other (department approved): No

ON-CALLNote that employees may be required to be on-call during emergencies (ie. Disaster, Severe Weather Events, etc) regardless of selection below.

• On Call* Yes

TRAVELTravel specifications may vary by department

• May require travel within the Houston Metropolitan area Yes
• May require travel outside Houston Metropolitan area No

QUALIFICATIONS

EDUCATION

• Graduate of education program approved by the credentialing body for the required credential(s) indicated below in the Certifications, Licenses and Registrations section.
• Bachelor's degree preferred

EXPERIENCE

• Three years hospital nursing clinical experience
• Case management experience preferred

LICENSES AND CERTIFICATIONS

Required

• RN - Registered Nurse - Texas State Licensure - Texas Board of Nursing_PSV Compact Licensure - Must obtain permanent Texas license within 60 days (if establishing Texas residency)

Company Profile:

Houston Methodist Willowbrook Hospital is a Magnet-recognized, not-for-profit, faith-based hospital that serves the growing Northwest Houston community. We are committed to providing quality, cost-effective health care in a compassionate environment for a full range of services, including emergency care, cardiology, orthopedics and sports medicine, comprehensive women's services, neurology and neurosurgery, oncology, and primary and general medicine.

Houston Methodist is an Equal Opportunity Employer.

APPLY

Join Our Talent Network

Featured Jobs

• Medical Laboratory Technician - Core Lab

Location:

Houston Methodist Hospital, Houston, TX

FLSA STATUS Non-exempt QUALIFICATIONS EDUCATION Graduate of education program approved by the credentialing body for the required credential(s) indicated below in the Certifications, Licenses and Registrations section EXPERIENCE One year of work or training experience in a hospital laboratory preferred LICENSES AND CERTIFICATIONS Required Must have one of the following

• MHT SAINT PSYCHIATRY

Location:

Houston Methodist Hospital, Houston, TX

FLSA STATUS Non-exempt QUALIFICATIONS EDUCATION High School diploma or equivalent education (examples include: GED, verification of homeschool equivalency, partial or full completion of post-secondary education, etc.) EXPERIENCE One (1) year of previous experience as a Mental Health Technician in a psychiatric/substance abuse setting Three (3) years' experience as a nursing/patient

• Patient Care Assistant/Unit Administrative Assistant - AOD

Location:

Houston Methodist Willowbrook Hospital, Houston, TX

FLSA STATUS Non-exempt QUALIFICATIONS EDUCATION High School diploma or equivalent education (examples include: GED, verification of homeschool equivalency, partial or full completion of post-secondary education, etc.) EXPERIENCE Eighteen months of Certified Nursing Assistant (CNA), Certified Medical Assistant (CMA) or Patient Care Assistant (PCA) experience One year of secretarial/office, college/vocational training,

Check out The Daily Dose

News from the

Houston Methodist Community

Houston Methodist Earns #1 Ranking on 2026 Modern Healthcare's 15 Top Health Systems

At Houston Methodist, high performance goes beyond a single hospital or moment in time. It is built into how our teams collaborate, innovate and care for patients every day. That commitment has earned Houston Methodist recognition as the #1 top performing health system in the 2026 Modern Healthcare's 15 Top

Houston Methodist Named a Forbes America's Best Large Employer for 2026

Houston Methodist is proud to be named to Forbes' America's Best Large Employers 2026 list, a significant national recognition that reflects how our employees experience working here every day. The list, developed by Forbes in partnership with Statista, was announced February 10, 2026. This honor is based on an extensive,

Houston Methodist Ranked No. 9 on Glassdoor's 2026 Best Places to Work list

Houston Methodist has earned a top spot on Glassdoor's 2026 Best Places to Work list, ranking No. 9 out of 100 of the Top 100 U.S. Employers and No. 1 in the health care industry. This national recognition is particularly meaningful because it is based entirely on feedback shared by

VISIT THE DAILY DOSE HOMEPAGE FOR MORE ARTICLES >>