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Sunshine Health
Austin, TX, United States
Care Manager RN - Pediatrics page is loaded Care Manager RN - Pediatrics Apply locations Austin-5900 E Ben White Blvd (10703) time type Full time posted on Posted 2 Days Ago job requisition id 1485236 You could be the one who changes everything for our 28 million members as a clinical professio
Job Source: Sunshine HealthSuperior HealthPlan
Austin, TX, United States
Job Description: You could be the one who changes everything for our 28 million members as a clinical professional on our Medical Management/Health Services team. Centene is a diversified, national organization offering competitive benefits including a fresh perspective on workplace flexibility. Must be licensed and reside in Texas Hybrid Position
Job Source: Superior HealthPlanSpectraforce Technologies
Austin, TX, United States
Job Title: Care Manager II (RN) Job Duration: 06 Months with possible extension Job Location: Austin, TX 78741 Position Purpose : 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. * Assess the m
Job Source: Spectraforce TechnologiesCVS Pharmacy
Austin, TX, United States
Bring your heart to CVS Health. Every one of us at CVS Health shares a single, clear purpose: Bringing our heart to every moment of your health. This purpose guides our commitment to deliver enhanced human-centric health care for a rapidly changing world. Anchored in our brand — with heart at its center — our purpose sends a personal message that h
Job Source: CVS PharmacyTexas Nursing Services
Austin, TX, United States
️ STICU and Trauma Care Unit RN Manager Position Available Annual Pay Range : $90,000-$130,000 Overview: Join our team in Austin, TX, as the STICU and Trauma Care Unit RN Manager. This role offers the opportunity to oversee the daily operations of our Trauma Care Unit and Trauma ICU, ensuring high-quality patient-centered care. Job Summary: As t
Job Source: Texas Nursing ServicesAxelon Services Corporation
Austin, TX, United States
Location: Field worker member facing; source from Austin, TX SHIFT: Business hours are typically 8-5 but due to the need to documentation is required to be submitted within turn around times it is important to note that more than 8 hours would be required at time to complete. Visits can run after 5pm due to the population of children being asses
Job Source: Axelon Services CorporationAffinity Executive Search
Austin, TX, United States
Job description: The Manager ensures high quality, patient-centered care through oversight of the overall daily function and staffing of the unit/department. The Manager monitors and evaluates the provision of nursing care in accordance with established policies/procedures and holds staff accountable for quality and clinical outcomes in support o
Job Source: Affinity Executive SearchPyramid Consulting, Inc
Austin, TX, United States
Immediate need for a talented STICU and Trauma Care Unit RN Manager . This is a Fulltime opportunity with long-term potential and is located in Austin, TX(Onsite) . Please review the job description below and contact me ASAP if you are interested. Job ID:24-15782 Pay Range: $130k - $150k/annum. Employee benefits include, but are not limited
Job Source: Pyramid Consulting, IncAustin, TX, United States
You could be the one who changes everything for our 28 million members as a clinical professional on our Medical Management/Health Services team. Centene is a diversified, national organization offering competitive benefits including a fresh perspective on workplace flexibility.
Must be licensed and reside in Texas
Hybrid Position - SDA Travis County
Position Purpose: 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.
Assess the member's current health status, resource utilization, past and present treatment plan and services, prognosis, short and long term goals, treatment and provider options
Utilize assessment skills and discretionary judgment to develop plan of care based upon assessment with specific objectives, goals and interventions designed to meet member's needs and promote desired outcomes
Coordinate services between Primary Care Physician (PCP), specialists, medical providers, and non-medical staff as necessary to meet the complete medical socio economic needs of clients
Provide patient and provider education
Facilitate member access to community based services
Monitor referrals made to community based organizations, medical care and other services to support the members’ overall care management plan
Actively participate in integrated team care management rounds
Identify related risk management quality concerns and report these scenarios to the appropriate resources.
Case load will reflect heavier weighting of complex cases than Care Manager I, commensurate with experience
Enter and maintain assessments, authorizations, and pertinent clinical information into various medical management systems
Direct care to participating network providers
Perform duties independently, demonstrating advanced understanding of complex care management principles.
Participate in case management committees and work on special projects related to case management as needed
Each position will be the delegated agency’s single point of contact to coordinate the overall CM activities provided to the target population
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 is aligned between the member, agency, and MCO
Facilitate member linkages to MCO-based services and programs in collaboration w/ agency staff
Assist members and/or agency staff w/ transportation to healthcare appointments
Communicate status of member health indicators with agency staff that can contribute the successful community living of members
Participate in weekly rounds w/ agency staff
Other duties as assigned
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.
Texas Requirements:
Education/Experience: Graduate from an Accredited School of Nursing. Bachelor’s degree in Nursing preferred. 2+ years of clinical nursing or case management experience in a clinical, acute care, managed care or community setting. 2+ years experience working with people with disabilities and vulnerable populations who have chronic or complex conditions in a managed care environment. Experience with medical decision support tools (i.e. Interqual, NCCN) and government sponsored managed care programs. Other state specific requirements may apply.
Pay Range: $66,100.00 - $118,900.00 per year
Our Comprehensive Benefits Package: 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.
Centene offers a comprehensive benefits package including: competitive pay, health insurance, 401K and stock purchase plans, tuition reimbursement, paid time off plus holidays, and a flexible approach to work with remote, hybrid, field or office work schedules. Actual pay will be adjusted based on an individual's skills, experience, education, and other job-related factors permitted by law. Total compensation may also include additional forms of incentives.
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Care Manager RN - Pediatrics jobs in Austin, TX, United States
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