Case Manager RN
3 days ago
We are seeking a highly skilled and compassionate Case Manager RN to join our team at Texas Children's Health Plan. As a Case Manager RN, you will play a vital role in providing comprehensive ongoing case management services to high-risk members, ensuring optimal member outcomes that address quality, service, customer satisfaction, and cost-effectiveness.
Responsibilities- Comprehensively assess member's biophysical, psychosocial, environmental, discharge planning needs, and financial status.
- Utilize concepts of reflection and motivational interviewing with the member and the entire family unit, through phone conversations and face-to-face conversations.
- Complete home visits to assess member's needs and provide support.
- Serve as a liaison with community organizations involved in the interests of the maternity and pediatric population.
- Maintain a flexible schedule for travel, some evenings, and weekends for member visits, health fairs, and member and community educational outreach.
- Accurately assess own learning needs and develop strategies to meet them.
- Stay informed of current healthcare developments to provide safe, quality nurse home visiting services.
- Assess resource utilization and cost management: the diagnosis, past and present treatment; prognosis and goals (short and long term).
- Diploma in nursing, Associate's degree in nursing, or an associate's degree in a related field accepted by the Texas Board of Nursing for the purposes of obtaining and maintaining an RN license required.
- Bachelor's degree in nursing preferred.
- RN license from the Board of Nurse Examiners for the state of Texas required.
- Driver's license required, own transportation.
- Auto insurance required.
- Case Management certification preferred.
- 3 years' clinical experience in pediatrics, including home care, case management, managed care, or utilization review required.
- Bilingual in Spanish and English strongly preferred.
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