Case Manager-RN-Road Warrior-Matagorda Area

 
Position: Case Manager-RN-Road Warrior-Matagorda Area

Job ID: 147659

Location: US-TX-Bellaire

Department: STAR KIDS CARE COORDINATION II

Talent Area: Registered Nurse

Full/Part Time: Full-Time

Regular/Temporary: Regular

Shift: 8a-5p

About Texas Children's Hospital

The Texas Children’s Hospital system is the largest pediatric integrated care system, and is an industry leader in pediatric population health. Founded in 1996, Texas Children’s Health Plan is the nation's first health maintenance organization (HMO) created just for children and pregnant women. We are an Integrated Community System providing holistic care that empowers families to live healthier lives.   Texas Children's Health 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 state territories (Harris, Jefferson, North East), who receive care from our network of more than 1,100 primary care physicians, 3,200 specialists, and 70 hospitals.   To join our community of 13,000 dedicated team members, visit www.texaschildrenspeople.org for career opportunities.   You can also learn more about our amazing culture at www.infinitepassion.org  

Summary:

We are searching for a Case Manager-Registered Nurse who is a Road Warrior for the Matagorda Area – someone who works well in a fast-paced setting, quick on their feet, able to make quick decisions. This role requires travel within the Matagorda area. This position 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 :

  • Completes home visits and clinic or hospital visits with Members as required.  

 

 

  • Utilize knowledge, experience and discretionary judgment to develop plan of care based upon assessment with specific objectives, goals and interventions designed to meet Member's needs and promote desired outcomes.

 

 

  • Assess the Member's current health status, resource utilization, past and present treatment plan and services, prognosis, short and long term goals, treatment and provider options.

 

 

  • Coordinate services between Primary Care Physician (PCP), specialists, medical providers, and non-medical staff as necessary to meet the complete medical socio economic needs of the Member.

 

 

  • Provide Member and Provider education.

 

 

  • Monitor referrals made to community based organizations, medical care and other services to support the Members’ Individual Service Plan.

 

 

  • Enter and maintain assessments, authorizations, and clinical information into various medical management systems.

 

 



Qualifications:

  • Associate’s degree in Nursing required (Bachelor’s degree in Nursing preferred) 
  • RN – Licensed Registered Nurses from the Board of Nurse Examiners for the State of Texas 
  • DL- Driver’s License for any state required 
  • INSURANC- Auto Insurance for current automobile required 
  • CASE MGM- Case Management experience preferred 
  • 3 years of clinical experience in pediatrics including the following areas of expertise: home care, case management, managed care or utilization review required 
  • Bilingual in Spanish and English preferred 
  • Must be okay with physical demands, sitting or standing for long period of time, and/or walk up and down stairs


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