Case Manager, Service Coordinator (RN) – Health Plan
- Assess, plan, implement, coordinate, monitor and evaluate options and services to meet members' health needs using motivational interviewing and a relationship-based approach.
- Utilize integrated case management (ICM) to assess members in four risks and needs domains (biological, psychological, social, and health system) which interact to create health complexity.
- Develop care plans in collaboration with members, Primary Care Providers (PCPs), and other members of their service coordination team
- Adhere to the Case Management Society of America's most recent version of the Standards of Practice for Case Management.
- Facilitate care transitions – Assist members and/or caregivers with navigating the health care system to achieve successful care transitions.
- Care transitions include changes in level of care (e.g. inpatient to outpatient) and youth to adult providers utilizing best practices and evidence-based guidelines when available.
- Provide consultation to other members of an interdisciplinary service coordination team that works in a coordinated fashion to assist members to achieve optimal health.
- Utilize evidence based guidelines to promote quality outcomes, member safety and satisfaction
- Evaluate the extent to which documented goals in the care plan/individual service plan (ISP) have been achieved.
- Incorporate health literacy (Teach Back) and other strategies to increase member safety into daily practice of case management.
- TX RN (Registered Nurse) required
- BSN and/or CCM preferred
- 2+ years' experience working with vulnerable populations and people with chronic or complex conditions
- 1+ years of similar experience in Managed Care environment
- 2+ years clinical experience required, ideally in pediatric environment
- Excellent time management and prioritization skills to focus on multiple projects simultaneously and adapt to change.
- Excellent oral and written communication skills.
- Strong personal computer skills, including working knowledge of Microsoft Office suite.
- Competitive Salary
- Full benefits package