"Lighting a Path to the Future"

Care Manager II- RN

Location: El Paso/Lubbock/Amarillo, TX
Job Type: Direct Hire
Salary: $60,000.00 - $72,000.00
Degree: Bachelor of Science; Licensed Practitioner;
Date: 10/11/2017
Job ID: 02529421
Job Description

Position Purpose:
Perform care management duties to assess, plan and coordinate all aspects of medical and supporting services across the continuum of care for select members to promote quality, cost-effective care.

Job Description

Care Manager II (RN) will report directly to the Service Coordination Manager.

  • 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
  • Utilize assessment skills 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
  • 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 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 the members’ overall care management plan
  • Actively participate in integrated team care management rounds
  • Identify related risk management quality concerns and report these scenarios to the appropriate resources.
  • Caseload will reflect heavier weighting of complex cases than Care Manager I, commensurate with experience
  • Enter and maintain assessments, authorizations, and pertinent clinical information into various medical management systems
  • Direct care to participating network providers
  • Perform duties independently, demonstrating an advanced understanding of complex care management principles.
  • Participate in case management committees and work on special projects related to case management as needed
Qualifications:
Texas Requirements:
Education/Experience:  
  • Graduate from an Accredited School of Nursing. Bachelor’s degree in Nursing preferred.
  • 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. 
  • Experience with medical decision support tools (i.e. Interqual, NCCN) and government-sponsored managed care programs. 
  • Other state specific requirements may apply.
  • Current state’s RN license.
Preferred:
  • Valid TX Driver's License
  • Applicants willing to travel up to 50%
  • Bilingual in English and Spanish (able to read and write)
Helpful: Pediatric Home Health and Psychiatric Nursing Experience

 




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Newman-Johnson-King, Inc. & A H Justice Search Consultants • 862 S. Bay St. • Aransas Pass, TX 78336 • Phone: 361-758-2410
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