Care Manager RN - Foster Care

Job Description

Come and join our team at Superior HealthPlan as a Care Manager RN for Foster Care. This position offers a fresh perspective on workplace flexibility and the opportunity to make a meaningful impact on the lives of our 28 million members. You will be responsible for performing care management duties to assess, plan, and coordinate all aspects of medical and supporting services across the continuum of care for select members, promoting quality and cost-effective care.

Responsibilities

• Assess the member's current health status, resource utilization, past and present treatment plan and services, prognosis, short and long term goals, treatment, and provider options.
• Develop plan of care based upon assessment with specific objectives, goals, and interventions designed to meet member's needs and promote desired outcomes.
• Monitor and facilitate member access to community-based services and coordinate services between primary care physicians, specialists, medical providers, and non-medical staff as necessary to meet the complete medical socio-economic needs of clients.
• Provide patient and provider education, monitor referrals, and participate in integrated team care management rounds.
• Actively identify related risk management quality concerns and report these scenarios to the appropriate resources.
• Enter and maintain assessments, authorizations, and pertinent clinical information into various medical management systems.
• Participate in case management committees and work on special projects related to case management as needed.

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.
• Knowledge of utilization management principles, healthcare managed care, and government-sponsored managed care programs.
• Current state’s RN license; Texas requirements: 2+ years of clinical nursing or case management experience in a clinical, acute care, managed care or community setting, 2+ years experience working with people with disabilities and vulnerable populations who have chronic or complex conditions in a managed care environment.

Benefits

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