Case Manager- Population Health at Texas Children's Careers

Bellaire, Texas, United States -

Full Time

Start Date

Immediate

Expiry Date

25 Mar, 26

Salary

0.0

Posted On

25 Dec, 25

Experience

2 year(s) or above

Remote Job

Yes

Telecommute

Yes

Sponsor Visa

Skills

Case Management, Nursing, Pediatrics, Home Care, Managed Care, Utilization Review, Assessment, Planning, Coordination, Implementation, Evaluation, Monitoring, Advocacy, Interdisciplinary Teamwork, Self-Care Support, Consumer Rights

Industry

Hospitals and Health Care

Description

We are searching for a Case Manager. Someone who will utilize a collaborative approach, the nurse case manager will assess, plan, implement, monitor and evaluate the options and services required to meet an individual's health needs. Provides comprehensive ongoing case management services to Texas Children's Health Plan members by coordinating and managing care of high-risk members in order to meet multiple service needs across the continuum of care, ensure optimal member outcomes that address quality, service, customer satisfaction and cost effectiveness. Assists the member/member's family in coping with illness by optimizing the member's/family's self-care abilities and supporting their consumer rights. Think you've got what it takes? Qualifications: Diploma in Nursing OR an Associate's degree Nursing or an associate’s degree in a related field accepted by the Texas Board of Nursing for the purposes of obtaining and maintaining an RN license OR Bachelor's Degree Nursing Licenses and Certifications Required RN - Lic-Registered Nurses Texas Board of Nursing or Nursing Licensure Compact required Case Management Certification preferred 3 years Clinical experience in pediatrics including the following areas of expertise: home care, case management, managed care or utilization review required. Responsibilities: Assesses, develops, implements and monitors a comprehensive plan of care through an interdisciplinary team process in conjunction with the member/family in internal and external settings Identification: Proactively identifies members in need of case management through clinical rounds, medical management staff referrals, consultation with primary HMO staff, medical director and PCP, parents, TCH staff, home care staff, and other internal TCHP areas. Assessment: Comprehensively assesses member’s biophysical, psychosocial, environmental, discharge planning needs and financial status. Participates in planning and coordinating services across the continuum of care and documents this plan in designated system. Planning and Coordination: Ensures for the provision of continuity of care needs as required and serves as advocate on behalf of members and families on an ongoing basis across the continuum of care. Implementation: Identifies problems/barriers/opportunities for intervention. Provides for resolution, revision of plans on an ongoing basis. Evaluation and Monitoring: Routinely assess member’s status and progress; if progress is static or regressive, determine the reason and proactively encourage appropriate adjustments in the care plan, providers and/or services to promote better outcomes.

Responsibilities

The Case Manager will assess, plan, implement, monitor, and evaluate care options for high-risk members. They will coordinate services across the continuum of care and advocate for members and their families.