Case Mgr. MA Integrated, El Paso Health

University Medical Center of El Paso • El Paso, TX

6d

About The Position

Ensures members with complex needs receive coordinated, integrated care across medical, behavioral, and community-based services. The position serves members enrolled in both Medicare and Medicaid through El Paso Health and coordinates benefits across both programs while working with Primary Care Providers (PCPs), specialists, and other providers to remove barriers to care.

Conducts screenings and assessments, develops and maintains person-centered Individual Service Plans (ISPs), and monitors services to ensure they remain appropriate and effective as member needs evolve. Serves as a member advocate, educating and assisting members, caregivers, medical consenters, and partner agencies—including Health and Human Services (HHSC) and the Department of Family and Protective Services (DFPS)—in navigating the healthcare system, accessing available services and supports, and understanding their rights throughout the process.

Requirements

• Three years of professional nursing or social work experience.
• Current, active, unrestricted license to practice as a Registered Nurse or Social Worker in Texas.
• Bachelor’s degree in Nursing or Social Work.
• Excellent verbal and written communication and interpersonal skills, demonstrated through past job experience.
• Strong analytical, data management, and computer skills; computer and typing skills are required.
• Ability to work with people of all social, economic, and cultural backgrounds.
• Flexibility, open-mindedness, and adaptability to change.
• Understanding of pre-acute and post-acute venues of care and community resources.
• Strong organizational and time-management skills, including the ability to prioritize multiple tasks and role components.
• Ability to work independently and exercise sound judgment in interactions with physicians, payors, and patients and families.
• Obtain Patient-Driven Payment Model (PDPM) for Long Term Care certification or Resource Utilization Group (RUG) certification within 90 days of starting the position.

Nice To Haves

• Previous experience as a Case Manager.
• Bilingual in English and Spanish.
• Certified Case Management (CCM).

Responsibilities

• Coordinate integrated medical, behavioral, and community-based care for members with complex needs enrolled in Medicare and Medicaid through El Paso Health.
• Coordinate benefits across Medicare and Medicaid and work with Primary Care Providers, specialists, and other providers to remove barriers to care.
• Conduct screenings and assessments.
• Develop and maintain person-centered Individual Service Plans (ISPs).
• Monitor services to ensure they remain appropriate and effective as member needs evolve.
• Advocate for members by educating and assisting members, caregivers, medical consenters, and partner agencies in navigating healthcare, accessing services and supports, and understanding their rights.

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level