Care Manager RN - Foster Care

Job Description

Superior HealthPlan is seeking a Care Manager RN to join our Medical Management/Health Services team. This is a hybrid position requiring pediatric experience and candidates must be licensed and reside in Texas.

Responsibilities

• Assess members' health status, resource utilization, treatment plans, and services.
• Develop care plans based on assessment with specific objectives and interventions.
• Coordinate services between medical providers and non-medical staff to meet members' needs.
• Provide patient and provider education and facilitate community-based services.
• Monitor referrals to support members' care management plans and participate in integrated team care management rounds.
• Identify and report related risk management quality concerns.
• Maintain assessments, authorizations, and clinical information in medical management systems.
• Participate in case management committees and special projects as needed.
• Coordinate overall care management activities and facilitate member linkages to MCO-based services and programs.
• Assist members and/or agency staff with transportation to healthcare appointments.
• Communicate status of member health indicators with agency staff.
• Participate in weekly rounds with agency staff and perform other duties as assigned.

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.
• Experience with utilization management principles, healthcare managed care, and medical decision support tools.
• Texas-specific requirements: 2+ years experience working with people with disabilities and vulnerable populations in a managed care environment. Other state-specific requirements may apply.

Benefits

• Flexible work solutions including remote options, hybrid work schedules, and dress flexibility.
• Competitive pay with a pay range of $66,100.00 - $118,900.00 per year.
• 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.