Care Coordinator (Utilization Management)

 
Position: Care Coordinator (Utilization Management)

Job ID: 159389

Location: US-TX-Houston

Department: UTILIZATION MANAGEMENT

Talent Area: Registered Nurse

Full/Part Time: Full-Time

Regular/Temporary: Regular

Shift: 6a - 4p

About Texas Children's Hospital

Founded in 1996, Texas Children’s Health Plan is the nation's first health maintenance organization (HMO) created just for children. We provide STAR/Medicaid and Children's Health Insurance Program (CHIP) to pregnant women, teens, children and adults in Houston and surrounding areas. Currently, the Health Plan has more than 375,000 members who receive care from our network of more than 1,100 Created 1.2020 primary care physicians, 3,200 specialists, and 70 hospitals. Texas Children's Health Plan is also the largest combined STAR/CHIP Managed Care Organization in the Harris County service area. To join our community of 14,000+ dedicated team members, visit texaschildrenspeople.org for career opportunities. You can also learn more about our amazing culture at infinitepassion.org. Texas Children’s is proud to be an equal opportunity employer. All applicants and employees are considered and evaluated for positions at Texas Children's without regard to mental or physical disability, race, color, religion, gender, national origin, age, genetic information, military or veteran status, sexual orientation, gender identity, marital status or any other protected Federal, State/Province or Local status unrelated to the performance of the work involved.

Summary:

We are searching for a Care Coordinator – 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 utilizing a collaborative approach. Additionally, you will provide comprehensive on-going case management services to patients by coordinating and managing care of patients to meet multiple service needs cross the continuum of care. You will also ensure optimal patient outcomes that address quality, service, customer satisfaction and cost effectiveness. The care coordinator will partner with the physician to establish care and allocate resources associated with the patient’s risk assessment and assist the patient/patient’s family in coping with illness by optimizing the patient’s/family’s self-care abilities and supporting their consumer rights.

 

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 patient/family in internal and external settings
  • Ensures quality, cost-effective use of resources and facilitates access to care
  • Collaborates with community health education/outreach organizations and providers to promote health for children with complex healthcare needs
  • Engages in professional development
  • Prepares and monitors outcome data to assist in identification of improvement opportunities
  • Demonstrates commitment to team, flexibility, professional interpersonal, communication, critical thinking, and customer service skills
  • Uses positive and effective interpersonal skills when dealing with patients/families, visitors, peers, and other healthcare team members
  • Serves as a patient/family advocate while caring for patients and collaborating with other healthcare team members
  • Assists in creating a positive work environment that promotes productivity, mentoring, teamwork, and cooperation


Qualifications:

Being fully vaccinated against COVID-19 is required for all employees at Texas Children’s, unless approved for a medical or religious exemption.

  • Bachelor's Degree in nursing required or
  • Associate degree in nursing with acceptance required or
  • Current enrollment in a BSN program and signed agreement or associate degree in a related field accepted by the Texas Board of Nursing for the purposes of obtaining and maintaining an RN license required or
  • Technical diploma in nursing with acceptance or current enrollment in a BSN program and signed agreement required or
  • Must be currently enrolled in a nursing bridge program working toward an MSN. Verified BSN-equivalency or a signed agreement is required.
  • Bachelor’s in nursing strongly preferred
  • RN - Lic-Registered Nurses Nurse Licensure Compact required
  • BLS - Cert-Basic Life Support American Heart Association required
  • PEARS - Cert-P.E.A.R. American Heart Association preferred
  • CCM - Cert-Certified Case Manager Commission for Case Manager Certification preferred
  • ACM - Cert-Accredited Case Manager American Case Management Association preferred
  • 3 years nursing experience in an acute care setting required
  • 3 year’s experience in community health, complex pediatric patient care, home care, case management, managed care, or utilization review preferred


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