Case Manager, Registered Nurse
HybridAustin, Texas, United States
Job Summary
Conduct comprehensive physical, medical, and psychological assessments on high-risk, high-cost patients via telephonic interviews. Establish care plans, goals, and contact schedules based on patient risk categories and identified medical or social needs. Promote compliance with disease-specific clinical outcomes by providing self-management supports, including education materials, nutritional recommendations, and activity plans. Coordinate care and communication among multiple providers across medical, nursing, social, and behavioral health sectors. Independently travel off-site to various locations as required. This remote role involves occasional visits to the Central Health office in Austin, Texas. Candidates must hold an active, unrestricted Registered Nursing license and obtain Commission for Case Manager Certification (CCMC).
Required Qualifications
- Completion of an accredited Registered Nursing Program
- 3 years of experience in community health setting, public health, chronic disease management, community nursing, case management
- Experience in care coordination and disease management/education
- Experience working with primary care providers in practice setting to coordinate care and disease management
- Strong communication skills, both verbal and written
- Knowledge of case management, disease management, and chronic care principles
- Active and unrestricted state Registered Nursing License in good standing
- Commission for Case Manager Certification (CCMC)
Desired Qualifications
- Experience in Medicaid Managed Care including STAR and CHIP
- Experience with Commercial, Health Care Exchange Programs and other county programs
- Ability to manage workload efficiently and effectively and within established policies and procedures
- Excellent interpersonal skills with the ability to interface and interact effectively with members, providers, health plan staff and other external customers
- Strong verbal, listening and written communication skills including detail oriented and concise documentation skills
- Knowledge of HHSC, TDI, NCQA and HEDIS regulations, standards, or measures to assure overall compliance with all standards
- Working knowledge in the use of a personal computer and of Microsoft Office products including Word, Excel, Outlook, and Power Point
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