Care Manager RN

Job Description: Care Manager RN

We are looking for a dedicated Care Manager RN to join Superior HealthPlan's Medical Management/Health Services team. As a key member of the team, you will be responsible for assessing, planning, and coordinating all aspects of medical and supporting services to ensure quality, cost-effective care for our select members. This hybrid position based in SDA Bryan/College Station, TX, offers an excellent opportunity to make a real difference in the lives of our members.

Responsibilities:

• Assess and evaluate members' health status, treatment plans, and service needs.
• Develop personalized care plans with specific objectives and interventions to meet members' needs.
• Coordinate services with healthcare providers and community resources to support members' overall well-being.
• Provide patient and provider education to enhance health outcomes.
• Participate in care management rounds and case management committees to ensure quality care delivery.
• Enter and maintain relevant clinical information in medical management systems.
• Coordinate service authorizations and ensure alignment between all stakeholders.
• Facilitate member linkages to various healthcare services and programs.

Education/Experience:

Graduate from an Accredited School of Nursing with a Bachelor's degree in Nursing preferred. You should have at least 2+ years of clinical nursing experience and 1+ years of case management experience in a managed care setting. Knowledge of utilization management principles, healthcare managed care, and medical decision support tools is essential.

Licenses/Certifications:

Current state RN license is required.

Pay Range:

$66,100.00 - $118,900.00 per year

Benefits:

• Competitive pay and comprehensive benefits package.
• Health insurance, 401K, and stock purchase plans.
• Tuition reimbursement and paid time off plus holidays.
• Flexible work options including remote, hybrid, field, or office work schedules.

Join our team at Superior HealthPlan, where we value diversity and are committed to creating an inclusive workplace for all. Apply now to be part of a rewarding career in care management!