RN Case Manager

Nexus Health Systems Ltd • Shenandoah, TX

2d • Onsite

About The Position

Nexus Children’s Hospital – Shenandoah specializes in providing comprehensive, pediatric-focused care for children and adolescents with complex medical, neurological, and rehabilitative needs. Our interdisciplinary approach supports recovery, independence, and long-term quality of life through coordinated medical care, therapy services, and family engagement. We are committed to empowering patients and families throughout their healthcare journey with compassion, expertise, and a collaborative spirit.

Requirements

• Current RN license in the State of Texas (required)
• Strong communication skills and ability to work effectively with families under stress

Nice To Haves

• Bachelor of Science in Nursing preferred
• Case Management certification (ACM or CCM) preferred
• Prior experience in pediatrics, rehabilitation, acute care, behavioral health, or complex medical case management strongly preferred
• Experience with utilization review or managed care interaction is a plus

Responsibilities

• Maintains PHI and HIPAA compliance according to hospital policy and federal regulations.
• Promotes a safe working environment and safe patient care at all times.
• Practices “minimum information necessary” when performing utilization review, case management, and discharge functions.
• Acts as a patient advocate for all patients within the facility.
• Adheres to all regulatory, company, and ethical standards of practice.
• Demonstrates respect, professionalism, and confidentiality at all times.
• Supports and models the organization’s mission, vision, and values.
• Conducts initial and ongoing patient assessments, focusing on clinical needs, discharge criteria, and family support.
• Plans, coordinates, and facilitates interdisciplinary care conferences.
• Evaluates ongoing treatment plans and collaborates with providers for necessary adjustments.
• Prevents service duplication and ensures appropriate use of resources.
• Collaborates with third-party payors to provide medical information and support authorization processes.
• Coordinates discharge planning, ensuring safe and effective transition to the next level of care.
• Serves as a primary communication point for patient families and outside agencies.
• Provides education regarding treatment goals, discharge needs, and community resources.
• Facilitates problem-solving and addresses barriers to discharge or care progression.

Benefits

• Competitive compensation & benefit package

What This Job Offers

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