Case Manager RN – STAR Kids – Health Plan

Category : Healthcare
Location/City : TX - Houston
Id : 29615


We are searching for a Case Manager RN - someone who works to utilize a collaborative approach to assess, plan, implement, monitor and evaluate the options and services required to meet an individual's health needs.
You will be responsible for providing comprehensive ongoing case management services to Texas Children's Health Plan members by coordinating and managing care of high risk members in order to meet multiple service needs across the continuum of care, ensure optimal member outcomes that address quality, service, customer satisfaction and cost effectiveness.
Think you've got what it takes?
Responsibilities:
  • Assesses, develops, implements and monitors a comprehensive plan of care through an interdisciplinary team process in conjunction with the member/family in internal and external settings
  • Performs all necessary communication and documentation functions
  • Collaborates with community health education/outreach organizations and providers to provide for the overall health promotion of TCHP members
  • Educates providers on network compliance and policies and procedures of the Texas Children's Health Plan, managed care and Medicaid
  • Accurately accesses own learning needs and developed strategies to meet them
  • Prepares and Monitors outcome data to assist in identification of improvement opportunities

Qualifications:
  • Bachelor of Science degree in Nursing or a graduate of an accredited school of nursing, and three (3) years equivalent experience
  • Must be registered and currently licensed by the Board of Nurse Examiners for the State of Texas
  • Minimum three (3) years of clinical experience in pediatrics including the following areas of expertise: home care, case management, managed care or utilization review
  • Current U.S. driver's license is required for all new hires/transfer effective 8/1/16
  • Current personal motor vehicle insurance is required for all new hires/transfer effective 8/1/16

Preferred:
  • Case Management Certification

EOE-M/F/V/D

Lets Go!