Registered Nurse-Case Manager

Job ID #1893451

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About this Role

Performs care management duties to assess and coordinate all aspects of medical and supporting services across the continuum of care for complex/high acuity populations with primary medical/physical health needs to promote quality, cost effective care. Develops a personalized care plan / service plan for long-term care members, addresses issues, and educates members and their families/caregivers on services and benefit options available to receive appropriate high-quality care.

Job details

$48.54 / hour

Mcallen, Edinburg, Pharr, Mission, and Weslaco, Texas

New

Profession: Registered Nurse

Facility Type: ???

Specialty: Case Manager

Division: MedFi

Start Date: 07/07/2025

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Responsibilities

Develops and continuously assesses ongoing long-term care plans / service plans and collaborates with care management team to identify providers, specialists, and/or community resources needed to address member's needs

Coordinates and manages as appropriate between the member and/or family/caregivers and the care provider team to ensure members are receiving adequate and appropriate person-centered care or services

Monitors care plans / service plans and/or member status, change in condition, and progress towards care plan / service plan goals

Monitors member status for complications and clinical symptoms or other status changes, including assessment needs for potential entry into a higher level of care and/or waiver eligibility, as applicable

Reviews member data to identify trends and improve operating performance and quality care in accordance with state and federal regulations

Reviews referrals information and intake assessments to develop appropriate care plans / service plans

Collaborates with healthcare providers as appropriate to facilitate member services and/or treatments and determine a revised care plan for member if needed

Collects, documents, and maintains all member information and care management activities to ensure compliance with current state, federal, and clinical guidelines

Provides and/or facilitates education to long-term care members and their families/caregivers on disease processes, resolving care gaps, healthcare provider instructions, care options, referrals, and healthcare benefits

Acts as liaison and member advocate between the member/family, physician, and facilities/agencies

Required Qualifications

2+ years RN experience required

Case management experience

RN license

Must be able to travel for visits

Strong computer and phone skills - MS office

Home health experience preferred

Must reside in Mcallen, Edinburg, Pharr, Mission, and Weslaco area TX