Care Manager RN - Foster Care

  • Superior HealthPlan
  • Houston, TX
  • time-alarm-solid 02-15-2024

Job Description

Superior HealthPlan is seeking a Care Manager RN - Foster Care to join our Medical Management/Health Services team in Texas. In this hybrid position, you will perform care management duties to assess, plan, and coordinate all aspects of medical and supporting services across the continuum of care for select members, ensuring quality and cost-effective care. As a Care Manager RN, you will apply your assessment skills and discretionary judgment to develop personalized care plans, facilitate member access to community-based services, and provide patient and provider education. Additionally, you will actively participate in integrated team care management rounds and identify related risk management quality concerns.

Responsibilities

  • Assess the member's current health status, resource utilization, past and present treatment plan and services
  • Coordinate services between healthcare providers and non-medical staff as necessary to meet the complete medical socio economic needs of clients
  • Provide patient and provider education
  • Facilitate member access to community-based services
  • Monitor referrals made to community-based organizations, medical care, and other services to support members' overall care management plan
  • Identify related risk management quality concerns and report to appropriate resources
  • Enter and maintain assessments, authorizations, and pertinent clinical information into various medical management systems
  • Participate in case management committees and work on special projects related to case management as needed

Requirements

  • Graduate from an Accredited School of Nursing
  • Bachelor’s degree in Nursing preferred
  • 2+ years of clinical nursing experience in a clinical, acute care, or community setting
  • 1+ years of case management experience in a managed care setting
  • Current state’s RN license
  • Texas Requirements: 2+ years of clinical nursing or case management experience in a clinical, acute care, managed care, or community setting
  • 2+ years' experience working with people with disabilities and vulnerable populations who have chronic or complex conditions in a managed care environment

Benefits

  • Competitive pay
  • Paid time off including holidays
  • Health insurance coverage for you and your dependents
  • 401(k) and stock purchase plans
  • Tuition reimbursement and best-in-class training and development
  • Flexible work solutions including remote options and hybrid work schedules