Care Manager RN - Foster Care

Job Description

Superior HealthPlan is seeking a qualified Care Manager RN to join our team. This hybrid position covers the SDA areas of Garland, Rockwall, Mesquite, Forney, Terrell, Kaufman, Ennis, Corsicana, Waxahachie, and Wills Point in Texas. As a Care Manager RN, you will be responsible for assessing, planning, and coordinating all aspects of medical and supporting services to promote quality, cost-effective care for select members.

Responsibilities

• Assess the member's current health status, resource utilization, treatment plan, and services
• Develop and implement personalized care plans to promote desired outcomes
• Coordinate services between medical providers, specialists, and non-medical staff
• Provide patient and provider education and facilitate access to community-based services
• Monitor referrals and report related risk management and quality concerns
• Enter and maintain assessments, authorizations, and clinical information into medical management systems
• Participate in case management committees and special projects related to case management

Requirements

• Bachelor's degree in Nursing preferred
• 2+ years of clinical nursing experience and 1+ years of case management experience
• Current state's RN license
• Experience in managed care, utilization management, and healthcare managed care
• Knowledge of medical decision support tools and government-sponsored managed care programs

Benefits

• Competitive pay range: $66,100.00 - $118,900.00 per year
• Flexible work solutions including remote options and hybrid work schedules
• Paid time off, health insurance, 401(k) and stock purchase plans
• Tuition reimbursement and best-in-class training and development