Case Manager-RN-Health Plan

Position: Case Manager-RN-Health Plan

Job ID: 147413

Location: US-TX-Bellaire

Department: Case/Disease Management

Talent Area: Registered Nurse

Full/Part Time: Full-Time

Regular/Temporary: Regular

Shift: 8a-5p

About Texas Children's Hospital

  Texas Children’s Health Plan (TCHP) is the largest Texas Medicaid managed care organization, and is part of the Texas Children’s healthcare system. Founded in 1996, TCHP is the nation's first health maintenance organization (HMO) created just for children and pregnant women. Our plan is also the largest combined STAR/CHIP Managed Care Organization in the Harris County service area. Currently the Health Plan serves more than 450,000 members across three service areas (Harris, Jefferson, North East). Members of the plan receive care from our network of more than 4,000 primary care physicians, 8,000 specialists, and 110 hospitals. They can also receive care at The Center for Children and Women, a patient and family-centered medical home with two convenient locations for TCHP members who can have all their medical needs met in one place, receiving multiple services the same day. TCHP is a recognized leader at encouraging holistic care that empowers families to live healthier lives.   To join our community of 13,000 dedicated team members, visit for career opportunities.   You can also learn more about our amazing culture at


We are searching for a Case Manager, RN – someone who works well in a fast-paced setting. In this position, you will assess, plan, implement, monitor, and evaluate the options and services required to meet an individual's health needs. You’ll provide comprehensive ongoing case management services to health plan members by coordinating and managing the care of high-risk members to meet multiple service needs across the continuum of care. This role will ensure optimal member outcomes that address quality, service, customer satisfaction, and cost-effectiveness. You’ll also assist the member/member's family in coping with illness by optimizing the member's/family's self-care abilities and supporting their consumer rights.


Think you’ve got what it takes?

Responsibilities :

  • Assess, develop, implement and monitor a comprehensive plan of care through an interdisciplinary team process in conjunction with the members/families in internal and external settings
  • Perform all necessary communication and documentation functions
  • Collaborate with community health education/outreach organizations and providers to provide for the overall health promotion of members
  • Conduct provider and member education activities and oversee professional development
  • Prepare and monitor outcome data to assist in the identification of improvement opportunities


  • Associate's degree, technical diploma, or bachelor’s degree in nursing required
  • RN – Licensed Registered Nurses from the Board of Nurse Examiners for the State of Texas
  • 3 years of clinical experience in pediatrics including the following areas of expertise: home care, case management, managed care or utilization review required

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