Case Manager RN
1 day ago
We are seeking a skilled Case Manager Registered Nurse to join our team at Texas Children's Health Plan. As a Case Manager Registered Nurse, you will play a critical role in coordinating and managing care for high-risk members, ensuring optimal member outcomes that address quality, service, customer satisfaction, and cost effectiveness.
Key Responsibilities:- Comprehensively assess members' biophysical, psychosocial, environmental, discharge planning needs, and financial status.
- Utilize concepts of reflection and motivational interviewing with members and their families through phone conversations and face-to-face interactions.
- Complete home visits to provide personalized care and 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, including 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.
About Us:
Texas Children's Health Plan is the nation's first health maintenance organization (HMO) created just for children. We provide STAR/Medicaid and Children's Health Insurance Program (CHIP) to pregnant women, teens, children, and adults in Houston and surrounding areas.
Currently, the Health Plan has more than 375,000 members who receive care from our network of more than 1,100 primary care physicians, 3,200 specialists, and 70 hospitals.
Texas Children's Health Plan is also the largest combined STAR/CHIP Managed Care Organization in the Harris County service area.
We are proud to be an equal opportunity employer and value diversity in our workplace.
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