RN Case Manager

Location: Corpus Christi, TX
Date Posted: 03-01-2018
Case Management Nurse (RN) - Managed Care
Corpus Christi, TX
Case Manager Job Summary:
  • The Case Manager plays an integral part in the coordination of care assessing the member’s condition and providing them the necessary resources, options, and coordination for a healthy care outcome.
  • The primary responsibility of the Nurse Case Manager is to coordinate and monitor the care of Health Plan members and develop a nursing plan of care.
  • They will participate in interdisciplinary conferences to review clinical assessments, update care plans and determine follow-up frequency.
  • The Case Manager also acts as an advocate for members and their families linking them to other members of the care team to help them gain knowledge of their disease process and to identify community resources for continued growth toward a maximum level of independence.
  • The Nurse Case Manager will work specifically on behalf of newborns, infants, children, and other pediatric members.  The focus of this position is the care coordination of pediatric members, children with special needs, and those enrolled in the Texas STAR+PLUS program.
Case Manager Background:
  • Valid, unrestricted state Registered Nurse (R.N.) license.
  • Certification in Case Management (CCM) is preferred.
  • 4-5 years’ acute care clinical nursing experience.
  • 1-2 years of pediatric nursing experience, in either a clinical or case management capacity.
  • Experience with Foster Care or Pediatric experience/home care experience.
  • 1-2 years’ experience with care coordination, utilization review and/or discharge planning.
  • Prefer 1+ year of Case Management experience is required in a Health Plan setting.
  • Experience working with Federal and State assistance programs (Medicare/Medicaid/etc).
  • Basic computer literacy (MS Office) and typing skills are necessary.

Mike Vega - CHP
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