Case Manager
About the job
- Graduation from an accredited school of professional nursing, or graduation from an accredited master's social work program.
- A current and valid license to practice as a Registered Nurse in Texas, or a current and valid Texas license as a Master Social Worker.
- Certification in Case Management within two years of hire.
- Three years of nursing or social work experience in an acute hospital-based or comparable clinical setting.
- Excellent interpersonal communication and negotiation skills.
- Demonstrated leadership skills.
- Strong analytical, data management, and personal computer skills.
- Current working knowledge of discharge planning, utilization management, case management, performance improvement, disease or population management, and managed care reimbursement.
- Understanding of pre-acute and post-acute care settings and community resources, physician office routines, transitional procedures, motivational interviewing, and change management.
- Strong organizational and time management skills with the capacity to prioritize multiple tasks and role components.
- Ability to work independently and exercise sound judgment when interacting with physicians, payors, patients, and families.
- Effective oral and written communication skills.
- Coordinate and facilitate patient care progression throughout the continuum.
- Maintain active communication with physicians, nursing staff, and multidisciplinary care team members to provide timely and appropriate care.
- Address and resolve system problems that impede diagnostic or treatment progress.
- Identify and resolve delays and obstacles to discharge.
- Seek consultation from appropriate disciplines and departments to expedite care and facilitate discharge.
- Use conflict resolution skills to ensure timely resolution of issues.
- Facilitate care for an assigned caseload, monitor patient progress, and intervene as appropriate to ensure patient-focused, high-quality, efficient, and cost-effective care.
- Complete and report diagnostic testing, complete treatment and discharge plans, modify plans of care as needed, and communicate relevant information to third-party payors and the care team.
- Assign appropriate levels of care.
- Complete required documentation in TQ screens and patient records.
- Collaborate with medical, nursing, and ancillary staff to eliminate barriers to efficient care delivery.
- Complete utilization management and quality screening for assigned patients.
- Apply approved clinical appropriateness criteria to monitor admissions and continued stays and document findings according to department standards.
- Identify at-risk populations using approved screening tools and monitor length of stay and ancillary resource use.
- Take actions to achieve continuous improvement.
- Refer cases and issues to the Care Management Medical Director and follow up as indicated.
- Communicate with the Resource Center to facilitate covered-day reimbursement certification.
- Discuss payor criteria and issues with clinical staff and resolve payor problems as needed.
- Use quality screens to identify potential issues and forward information to the Clinical Quality Review Department.
- Ensure that critical elements of the plan of care are communicated to patients, families, and healthcare team members and documented for continuity of care.
- Manage all aspects of discharge planning for assigned patients.
- Meet with patients and families to assess needs and develop individualized continuing care plans with physicians.
- Collaborate with the multidisciplinary team throughout assessment, planning, implementation, teaching, and evaluation of discharge planning.
- Maintain consensus on the plan among patients or families, physicians, and payors.
- Refer appropriate cases for social work intervention.
- Collaborate and communicate with external case managers.
- Initiate and facilitate referrals for home health care, hospice, medical equipment, and supplies.
- Document discharge planning information in the medical record.
- Facilitate transfers to other facilities as appropriate.
- Participate in clinical performance improvement activities.
- Assist with collecting and reporting financial indicators, including case mix, length of stay, cost per case, excess days, resource utilization, readmission rates, denials, and appeals.
- Use fiscal, clinical, and patient satisfaction data to make decisions and implement case management performance improvement strategies.
- Collect, analyze, and address variances from the plan of care or care path with physicians and healthcare team members.
- Use concurrent variance data to drive practice changes and improve outcomes.
- Collect delay and other data for performance and outcome indicators and document relevant clinical path variances and outcomes.
- Use pathway data with other disciplines to ensure effective concurrent patient management.
- Lead the development, implementation, evaluation, and revision of clinical pathways and case management tools.
- Assist in compiling physician profile data regarding length of stay, resource utilization, denied days, costs, case mix index, patient satisfaction, and quality indicators.
- Serve as a preceptor and mentor to new hires.
- Assist in developing orientation schedules and identifying individual learning needs.
- Ensure safe care and follow organizational policies, procedures, standards, budgetary specifications, time management, supply management, productivity, and service-quality requirements.
- Maintain professional growth through mandatory and continuing education and skills competency requirements.
- Support department goals and serve as a preceptor, mentor, and resource to less experienced staff.
- Provide compassionate, personalized, safe, and efficient experiences to patients and colleagues.
- Perform other duties as assigned.
- A Bachelor of Nursing degree.
- A Licensed Clinical Social Worker license.
- Experience in acute hospital-based nursing or social work, or comparable clinical experience, is preferred.
- Experience in utilization management, case management, discharge planning, or another cost or quality management program is preferred.
About the company
Memorial Hermann Health System is a nonprofit, community-owned health system serving the Greater Houston area with more than 260 care delivery sites. It delivers safe, high-quality, patient-centered care through an integrated network that combines clinical expertise with advanced technology. The system differentiates itself through its community ownership, value-driven culture, and broad network of hospitals, clinics, and specialty services. Its goal is to improve regional health outcomes by providing comprehensive, accessible care and leveraging innovation to personalize treatment.
Company Size
10,001+
Company Stage
Grant
Total Funding
$5M
Headquarters
Houston, Texas
Founded
1907
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Simplify's Take
What believers are saying
- September 29, 2026 retirement announcement sets up Jason Glover succession planning before 2027.
- September 2026 behavioral health rollout at 17 clinics broadens primary-care capture.
- Houston growth and Memorial Hermann-Texas Medical Center's teaching role sustain referral inflows.
What critics are saying
- 2026 CEO retirement creates succession risk during payer pressure and Houston competition.
- September 2026 hidden-camera lawsuit at The Woodlands damages trust and invites discovery.
- A widening privacy scandal could impair physician recruitment, patient volumes, and employer contracts.
What makes Memorial Hermann unique
- Memorial Hermann's 18-hospital Houston network spans 280 care sites and 35,000 employees.
- September 2026 Epic Art deployment reduced test-result follow-ups 32% across the system.
- August 2026 PartsSource investment and Helix genomic partnership deepen operational and precision capabilities.
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Benefits
Professional Development Budget
Wellness Program
Mental Health Support
Growth & Insights and Company News
6 month growth
↑ 14%1 year growth
↑ 14%2 year growth
↑ 14%Memorial Hermann CEO to retire at end of year. September 28, 2026 11:42 AM CDT Memorial Hermann Health System President and CEO Dr. David Callender will retire at the end of the year. Unlock full access today. Standard - Monthly $18 /month
Children's Memorial Hermann Hospital ranks No. 3 in Texas, among top Children's Hospitals in nation for 2026-2027 by U.S. News & World Report. World · SEP 15, 2026 PR Newswire HOUSTON, Sept. 15, 2026 /PRNewswire/ - Memorial Hermann Health System is proud to announce that Children's Memorial Hermann Hospital has once again been... HOUSTON, Sept. 15, 2026 /PRNewswire/ - Memorial Hermann Health System is proud to announce that Children's Memorial Hermann Hospital has once again been recognized as a Best Children's Hospital for 2026-2027 by U.S. News & World Report. The Best Children's Hospital rankings feature state and regional rankings, where Children's Memorial Hermann Hospital ranked as the No. 3 Best Children's Hospital in Texas, up from No. 5 last year, and No. 3 in the Southwest Region, up from No. 6 last year. In addition, the following pediatric subspecialties have ranked in the top 50 in the nation: * No. 12 in Cardiology and Heart Surgery * No. 26 in Neonatology * No. 28 in Gastroenterology and GI Surgery * No. 34 in Neurology and Neurosurgery * No. 40 in Orthopedics * No. 50 in Nephrology * Top 50 in Behavioral Health (no ordinal rankings) "To see Children's Memorial Hermann Hospital rise to No. 3 in both Texas and the Southwest Region, while expanding from five to seven nationally ranked specialties, is an incredible testament to our teams and the care they provide every day," said Guy Giesecke, CEO of Children's Memorial Hermann Hospital. "These rankings reflect the expertise, collaboration and commitment of our physicians, nurses and team members, as well as our strong partnership with McGovern Medical School at UTHealth Houston. Most importantly, they represent our shared commitment to giving children and families access to outstanding care when they need it most." The annual Best Children's Hospitals rankings and ratings are designed to assist patients, their families and their doctors in making informed decisions about where to receive care for challenging health conditions. The Best Children's Hospitals methodology factors objective measures such as patient outcomes, including mortality and infection rates, as well as available clinical resources and compliance with best practices. Other Memorial Hermann hospitals also ranked nationally in the Best Hospital rankings for 2026-2027, including: * TIRR Memorial Hermann ranked No. 1 in Texas and No. 4 among the country's top rehabilitation hospitals. * Memorial Hermann-Texas Medical Center (TMC) ranked as the No. 4 hospital in Houston and No. 6 in Texas. Obstetrics & Gynecology (OB/GYN) services entered the national top 50 rankings at No. 42. * Memorial Hermann Memorial City Medical Center ranked as the No. 9 hospital in Houston and No. 15 in Texas. * Memorial Hermann Sugar Land Hospital ranked No. 13 in Houston and No. 30 in Texas. The hospital was also the first-time recipient of the "Best Regional Hospital for Community Access." This ranking is related to the care of socioeconomically vulnerable populations. Key indicators include the treatment of Medicaid beneficiaries, racial and ethnic minority representation, and the proportion of care delivered to patients from socioeconomically deprived neighborhoods. * Memorial Hermann Rehabilitation Hospital-Katy is ranked No. 4 in Houston and No. 15 in Texas among rehabilitation hospitals. This location is a part of the Memorial Hermann Rehabilitation Network that also includes TIRR Memorial Hermann. Children's Memorial Hermann Hospital was founded in 1986 and offers care in more than 40 pediatric and women's related specialties including the latest advances in maternal-fetal medicine and neonatal critical care services, and renowned programs in fetal, pediatric trauma, neurosciences and cardiac care. SOURCE Memorial Hermann Health System Published by News Desk · WeeklyReviewer The WeeklyReviewer news desk monitors breaking developments around the clock - sourcing, verifying, and publishing real-time industry news across business, technology, politics, science, sports, and world affairs. Every story that comes through the Live Wire is reviewed for accuracy before publication, keeping our readers ahead of the curve without the noise.
Memorial Hermann Health System clinicians are using Epic's AI tool, Art, to help patients better understand their test results. The AI-powered assistant generates initial draft patient notes in clear, patient-friendly language as clinicians review lab and imaging results. Since implementation, patients have sent 32% fewer follow-up messages about test results when clinicians used Art's draft. The tool has helped Memorial Hermann's care teams write over 55,000 messages to patients, with clinicians saving an average of nine seconds per result comment. Memorial Hermann piloted the feature in December 2025 in their innovation clinic before expanding system-wide. Dr Ryan Walsh, chief medical information officer, emphasised that the technology is designed to support, not replace, clinician judgment and patient relationships.
Memorial Hermann Health System launches behavioral health services to patients at various clinics. September 03, 2026, 13:00 GMT This partnership marks a significant step forward in integrated health care, seamlessly blending behavioral health with primary care," - Misty Hauser, vice president of operations, Memorial Hermann SCOTTSDALE, AZ, UNITED STATES, September 3, 2026 / EINPresswire.com / - Memorial Hermann Heath System is launching onsite behavioral health services at 17 clinics that will provide access to mental health and other services for patients across the system. Through an innovative collaboration with Scottsdale-based evolvedMD, a nationally recognized company that integrates behavioral health into primary care, Memorial Hermann Medical Group will have evolvedMD behavioral health therapists inside existing primary care offices. The therapists will work alongside Memorial Hermann providers and care team members to deliver a comprehensive, connected approach to care - a model proven to deliver better overall health outcomes. "This partnership marks a significant step forward in integrated health care, seamlessly blending behavioral health with primary care," said Misty Hauser, vice president of operations, hospitalists, for Memorial Hermann. "This collaboration aims to enhance patient outcomes by allowing for comprehensive care to address both physical and mental health needs, fostering a holistic approach to wellness." According to the Centers for Disease Control and Prevention, more than one in five U.S. adults live with a mental illness. "Expanding into and throughout Texas is an important milestone for evolvedMD," said Erik Osland, Co-CEO of evolvedMD. "Memorial Hermann shares our commitment to whole-person care, and this partnership brings behavioral health support to patients across clinics within their trusted primary care setting. We look forward to bringing the same measurable, meaningful impact we've delivered in other regions to patients in Texas." About evolvedMD: Launched in 2017, evolvedMD is leading the integration of behavioral health services in modern primary care. Uniquely upfront and ongoing, our distinctive model places behavioral health specialists onsite within a practice. evolvedMD offers an economically viable and better way to integrate behavioral health that ultimately drives improved patient outcomes. To learn more, visit www.evolvedmd.com. About Memorial Hermann Health System Charting a better future. A future that's built upon the HEALTH of our community. This is the driving force for Memorial Hermann, redefining health care for the individuals and many diverse populations we serve. Our 6,600 affiliated physicians and more than 35,000 employees practice the highest standards of safe, evidence-based, quality care to provide a personalized and outcome-oriented experience across our more than 280 care delivery sites. As one of the largest nonprofit health systems in Southeast Texas, Memorial Hermann has an award-winning and nationally acclaimed Accountable Care Organization, 18 hospitals and numerous specialty programs and services conveniently located throughout the Greater Houston area. Memorial Hermann-Texas Medical Center is one of the nation's busiest Level I trauma centers and serves as the primary teaching hospital for McGovern Medical School at UTHealth Houston. For 118 years, our focus has been the best interest of our community, contributing nearly $500 million annually through school-based health centers and other community benefit programs. Now and for generations to come, the health of our community will be at the center of what we do - charting a better future for all. Legal Disclaimer: EIN Presswire provides this news content "as is" without warranty of any kind. We do not accept any responsibility or liability for the accuracy, content, images, videos, licenses, completeness, legality, or reliability of the information contained in this article. If you have any complaints or copyright issues related to this article, kindly contact the author above. You just read: September 03, 2026, 13:00 GMT EIN Presswire's priority is author transparency. We do our best to weed out false and misleading content. The content above is the sole responsibility of the author who makes it available. If you have any complaints, kindly contact the author above. Courtney Nelson +1 480-620-3006
Memorial Hermann earns top AHA awards for exceptional stroke care. Memorial Hermann Katy Hospital, 23900 Katy Freeway in Katy, is one of ten of the health system's acute care hospitals receiving the American Heart Association's "Get With The Guidelines(R)- Stroke Gold Plus Quality Achievement Award," recognizing their commitment to providing care that follows the latest, research-backed treatment guidelines proven to save lives and reduce disability after stroke. CONTRIBUTED PHOTO Posted Friday, August 28, 2026 5:29 pm CONTRIBUTED REPORT Memorial Hermann has once again been nationally recognized by the American Heart Association (AHA) for delivering fast, evidence-based stroke care that gives patients the best chance at recovery, the hospital system announced on August 18. Ten of the health system's acute care hospitals received the AHA'S "Get With The Guidelines(R)- Stroke Gold Plus Quality Achievement Award," recognizing their commitment to providing care that follows the latest, research-backed treatment guidelines proven to save lives and reduce disability after stroke. The hospitals included: · Memorial Hermann Cypress Hospital · Memorial Hermann Greater Heights Hospital · Memorial Hermann Katy Hospital · Memorial Hermann Memorial City Medical Center · Memorial Hermann Pearland Hospital · Memorial Hermann Southeast Hospital · Memorial Hermann Southwest Hospital · Memorial Hermann Sugar Land Hospital · Memorial Hermann-Texas Medical Center · Memorial Hermann The Woodlands Medical Center Adding to this year's honors, Memorial Hermann Southeast Hospital advanced from the Silver to Gold Plus award, while Memorial Hermann Southwest Hospital earned the "Target: StrokeSM Honor Roll Advanced Therapy" award for the first time, recognizing their ability to quickly deliver advanced treatment to patients experiencing certain types of stroke. "Stroke is a medical emergency and every second matters," said Memorial Hermann's System Stroke Program Director Sandi Shaw. "It's an honor to have the American Heart Association recognize the incredible work happening across our hospitals every day to ensure patients receive the right treatment as quickly as possible. These awards are a testament to the teamwork of our emergency physicians, neurologists, nurses, EMS partners and countless others who work together to improve outcomes for our patients." In addition to AHA "Get With The Guidelines," the following campuses received the AHA's Target: StrokeSM awards for meeting specific criteria that reduces the time between an eligible patient's arrival at the hospital and treatment with thrombolytic therapy. Target: StrokeSM Honor Roll Elite Plus was awarded to: · Memorial Hermann Memorial City Medical Center · Memorial Hermann Southwest Hospital · Memorial Hermann-Texas Medical Center · Memorial Hermann The Woodlands Medical Center Target: StrokeSM Honor Roll Elite was awarded to: · Memorial Hermann Cypress Hospital · Memorial Hermann Greater Heights Hospital · Memorial Hermann Katy Hospital · Memorial Hermann Sugar Land Hospital · Memorial Hermann Pearland Hospital Target: StrokeSM Honor Roll was awarded to: · Memorial Hermann Southeast Hospital Target: StrokeSM Honor Roll Advanced Therapy was awarded to: · Memorial Hermann The Woodlands Medical Center · Memorial Hermann Southwest Hospital Finally, nine campuses were also recognized with the AHA's Target: Type 2 Diabetes(TM) Honor Roll award that aims to offer patients with type 2 diabetes, who might be at higher risk for complications, the most up-to-date, evidence-based care when hospitalized due to stroke. These campuses included: · Memorial Hermann Cypress Hospital · Memorial Hermann Greater Heights Hospital · Memorial Hermann Katy Hospital · Memorial Hermann Pearland Hospital · Memorial Hermann Southeast Hospital · Memorial Hermann Southwest Hospital · Memorial Hermann Sugar Land Hospital · Memorial Hermann-Texas Medical Center · Memorial Hermann The Woodlands Medical Center For more information about Memorial Hermann's award-winning stroke care, visit www.memorialhermann.org/services/treatments/stroke-treatment or call 713-222-CARE (2273). Other items that may interest you