Care Manager RN - Foster Care

Job Description

We are looking for a skilled Care Manager RN to join our Medical Management/Health Services team at Superior HealthPlan. In this role, you will be responsible for assessing, planning, and coordinating all aspects of medical and support services for select members to ensure quality and cost-effective care. This position requires a Texas nursing license and pediatric experience.

Responsibilities

• Assess members' health status, develop care plans, and coordinate services across the care continuum.
• Provide patient and provider education, facilitate access to community-based services, and monitor referrals.
• Participate in care management rounds, identify quality concerns, and maintain clinical records.
• Serve as the primary contact for coordinating care management activities and services.
• Collaborate with agency staff to ensure member health and community living success.

Requirements

• Graduate from an Accredited School of Nursing, RN license in Texas.
• 2+ years of clinical nursing experience, 1+ year of case management in a managed care setting.
• Knowledge of healthcare managed care, utilization management principles, and medical decision support tools.
• Pediatric experience and familiarity with Interqual, NCCN tools preferred.

Salary Range

$66,100.00 - $118,900.00 per year, based on skills and experience. Comprehensive benefits package available, including health insurance, 401K, tuition reimbursement, and flexible work schedules.