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RN Case Manager - Team Leader/Educator

UMC Health System

Lubbock, TX
Job Code:
  • Administrative / Clerical
  • Customer Service
  • Education
  • Healthcare
UMC Health System
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Job Details

Title: RN Case Manager - Team Leader/Educator
JobID: 5565

Under general supervision by the Director of Case Management, Nurse (RN) Case Manager-Team Leader/Educator has the responsibility to case manage and provide utilization review for all patients who are in the acute setting, outpatient setting, and serve as the educator for the case management department.  The team leader also has the opportunity to lead innovative projects as directed by the Director of Case Management.


1.            Review and manage utilization review cases.
2.            Serves as coverage for case managers for utilization review, coordination of care, readmissions, and outpatient projects.
3.            Lead new projects, run reports, and collaborate to meet project goals and 1115 Waiver metrics.
4.            Educate the department on new CMS rules, 1115 Waiver metrics, and outpatient services.
5.            Responsible for Initial Assessment for potential patient in the outpatient setting (Home-Visits to              support environmental and physical assessments).
6.            Responsible for ensuring coordination of care for inpatient, observation, and outpatient               patients across the healthcare continuum.
7.            Responsible for the leading both inpatient and outpatient case managers to fulfilling job               expectations.
8.            Responsible for staff scheduling and new hire training.
9.            Acts as a liaison between the patients and interdisciplinary team members.
10.         Acts as a liaison between outpatient services and inpatient teams to ensure adequate   coordination and effectiveness of program delivery.
11.         Provides case management staff education on chronic disease and management across the        continuum.
12.         Develops up-to-date education materials to case management and patients.
13.         Troubleshoots issues with case managers, social workers, providers, and case management        directors.
14.         Functions as patient advocate.
15.         Ensures the implementation and compliance of patient care.
16.         Collaborates and supports and reports policies and procedures as necessary for UMC.
17.         Participates as an active member of the case management team.
18.         Collaborates and coordinates to ensure efficient operations i.e. staffing.
19.         Maintains acceptable standards of case management nursing care, based on ACMA and CMS      guidelines, as well as DNV standards.
20.         Assists with preparing for various audits.
21.         Assumes the role of supervisor, nursing in his/her absence and assists in completing       subordinate’s performance evaluations as/if needed.
22.         Leads meetings with various UMC departments to implement new processes approved by case management director. 
23.         Incorporates innovative, research-based practice into the current case management model.
24.         Performs other related duties as assigned by case management director and/or administrative team.


1.            Excellent customer service skills and ability to resolve complex customer service issues and         exercise conflict management.
2.            Ability to lead innovative projects.
3.            Ability to read, write and speak in a clear, accurate and professional manner; includes active       listening skills and understanding medical and social needs of the patient population.
4.            Ability to learn and efficiently run software systems including but not limited to CERNER, IDX,     Allscripts, and Excel.
5.            Proficient in intermediate computer skills and typing.
6.            Excellent follow through skills and attention to detail.
7.            Ability to work effectively with a diverse population/cultural differences.
8.            Ability to handle multiple tasks and meet deadlines.
9.            Ability to work in a fast-paced environment, drive change efforts and adapt to change.
10.         Knowledge of case management concepts.
11.         Knowledge of HIPAA Guidelines.
12.         Excellent health assessment skills relating to chronic disease, vulnerable, and/or high risk              populations.
13.         Knowledge of preventative measures for “at risk” patients.
14.         Ability to function as an effective leader and member of the team.
15.         Ability to drive as needed and participate in care plans in patient homes.

1.            Current valid License as a Registered Nurse through the Texas Board of Nursing.
2.            A minimum of two years in case management inpatient and outpatient preferred.
3.            A minimum of two years of experience in utilization review preferred.
4.            A minimum of one year experience preferred in managed care setting, inpatient, and outpatient             setting preferred.
5.            A minimum of two years in a leadership, coordinator, and/or educator position preferred.
6.            CPR/First Aid Certificate required.
7.            ACM or CCM preferred.
8.            BSN required, MSN preferred.

Job Type: Full time
Category: Nursing
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