Care Manager RN - Foster Care

Job Description

You could be the one who changes everything for our 28 million members as a clinical professional on our Medical Management/Health Services team at Superior HealthPlan. We are seeking a highly qualified Care Manager RN to perform care management duties, 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. This is a hybrid position based in Texas, and pediatric experience is required. The pay range for this position is $66,100.00 - $118,900.00 per year. As a Care Manager RN, you will be responsible for assessing 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. You will also 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, and monitor referrals made to community-based organizations, medical care, and other services to support the members’ overall care management plan.

Responsibilities

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

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 and 1+ years of case management experience in a managed care setting
• Current state’s RN license

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, hybrid work schedules, and dress flexibility