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About the position
We are searching for a Case Manager- someone who will be utilizing a collaborative approach. The nurse case manager will assess, plan, implement, monitor and evaluate the options and services required to meet an individual's health needs. Provides comprehensive ongoing case management services to Texas Children's Health Plan members by coordinating and managing care of high risk members in order to meet multiple service needs across the continuum of care, ensure optimal member outcomes that address quality, service, customer satisfaction and cost effectiveness. Assists the member/member's family in coping with illness by optimizing the member's/family's self-care abilities and supporting their consumer rights.
Responsibilities
- Assesses, develops, implements and monitors a comprehensive plan of care through an interdisciplinary team process in conjunction with the member/family in internal and external settings
- Performs all necessary communication and documentation functions
- Collaborates with community health education/outreach organizations and providers to provide for the overall health promotion of TCHP members
- Conducts provider and member education activities
- Professional Development
- Prepares and Monitors outcome data to assist in identification of improvement opportunities
Requirements
- Diploma in Nursing, associate's degree, or a bachelor's degree in Nursing required
- RN - Lic-Registered Nurses Texas Board of Nursing or Nursing Licensure Compact required
- Case Management Certification preferred
- 3 years Clinical experience in pediatrics including the following areas of expertise: home care, case management, managed care or utilization review required
