Salary Range: $40.00 - $45.00 per hour
Posted on
Job Description: Perform 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.
Education/Experience: Graduate from an Accredited School of Nursing. Bachelor’s degree in Nursing preferred. 2+ years of clinical nursing experience in a clinical, acute care, or community setting and 1+ years of case management experience in a managed care setting. Knowledge of utilization management principles and healthcare managed care. Experience with medical decision support tools (i.e. Interqual, NCCN) and government sponsored managed care programs.
Licenses/Certifications: Current state’s RN license.
Job Title: Registered Nurse- Care Management- Urgent hiring
Pay range $40-45 an hour
Hybrid
Duties
• Review emails to check time sensitive emails.
• Perform self- scheduled assessments timely based on reports provided by leadership, complete visit documentation timely. Evaluate members for possible community relocations.
• Review task queue and complete tasks as needed.
• Make follow up attempts as required, collaborate with nursing facility staff to ensure that members are safe, attend Nursing facility required monthly care plan meetings,
• obtain required items to meet member needs and obtain member satisfaction to meet compliance and contractual requirements.
• Complete in-person follow up with members and provide updates for in-jeopardy investigations.
• Attends scheduled team meetings. Complete assigned mandatory HHSC Centene University trainings.
• Complete all tasks, in-person assessments, mandatory training, and any additional outreaches timely to ensure member safety, satisfaction, and needs to meet compliance and contractual requirements.
• Maintain & promote an all- inclusive environment.
• register for RUG certification.
Critical thinking skills and ability to use nursing judgement for health risk assessments to ensure member safety.
Strong communication skills and ability to work independent with less supervision
Home health or nursing facility clinical experience along with at least 1 year of hospital experience.
Strong work ethic, ability to prioritize and adapt to changes
Licenses/Certifications: Current state’s RN license.
What previous job titles or background
• Home health or any other job which performs in home assessments.
• Previous clinical experience with nursing facility.
• Previous experience with managed care.
Education
Graduate from an Accredited School of Nursing. Bachelor’s degree in Nursing preferred.
2+ years of clinical nursing experience in a clinical, acute care, or community setting
1+ years of case management experience in a managed care setting.
Knowledge of utilization management principles and healthcare managed care.
Experience with medical decision support tools (i.e. Interqual, NCCN) and government sponsored managed care programs.
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