Care Manager RN - Foster Care

Job Description

Join our team at Superior HealthPlan as a Care Manager RN for Foster Care. This hybrid position, based in Texas, involves performing care management duties to assess, plan, and coordinate all aspects of medical and supporting services across the continuum of care for select members to promote quality, cost-effective care.

Responsibilities

• Assess the member's current health status, resource utilization, treatment plan and services, prognosis, and goals
• Develop a plan of care based upon assessment with specific objectives, goals, and interventions
• Coordinate services between healthcare providers to meet the medical, socio-economic needs of clients
• Provide patient and provider education
• Facilitate member access to community-based services and monitor referrals
• Participate in integrated team care management rounds and identify related risk management quality concerns
• Maintain assessments, authorizations, and pertinent clinical information into various medical management systems
• Participate in case management committees and work on related special projects
• Review and approve the initial and ongoing assessment and care plan to ensure requirements are met
• Coordinate service request/authorizations with UM and ensure agreement alignment
• Facilitate member linkages to MCO-based services and programs in collaboration with agency staff
• Assist members and/or agency staff with transportation to healthcare appointments
• Participate in weekly rounds with agency staff
• Perform other assigned duties

Requirements

• Graduate from an Accredited School of Nursing. Bachelor’s degree in Nursing preferred
• 2+ years of clinical nursing experience, with 1+ years of case management experience in a managed care setting
• Current state’s RN license
• Experience with medical decision support tools and government-sponsored managed care programs
• Texas residence and licensure
• Experience working with people with disabilities and vulnerable populations within the managed care environment

Benefits

• Flexible work solutions including remote options, hybrid work schedules and dress flexibility
• Competitive pay
• 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