RN Case Manager

This is a fully remote position, open to applicants in Texas.

📋 Description

• Perform telephonic evaluations for high-risk individuals

• Create personalized care plans and quantifiable health objectives

• Facilitate collaboration among providers, behavioral health teams, community resources, and members

• Provide education to members on managing chronic diseases, preventive care, medications, nutrition, and healthy lifestyle choices

• Aid in care transitions and eliminate obstacles to treatment

• Maintain precise documentation and ensure adherence to regulatory standards

• Advocate for members and assist them in navigating the healthcare system

• Enhance long-term health outcomes for Medicaid and underserved communities

⛳️ Requirements

• Must hold an active, unrestricted Texas RN license in good standing

• Candidate must reside in Texas

• At least 3 years of experience in community health, public health, chronic disease management, community nursing, or case management

• Minimum of 1 year of experience in care coordination and disease management/patient education

• Over 3 years of experience coordinating care with primary care providers

• Experience in outpatient case management within a health insurance, payer, or managed care setting

• Medicaid Managed Care experience is preferred

• Experience with Marketplace or Commercial Health Plans is preferred

• Familiarity with NCQA, HEDIS, HHSC, and TDI standards is preferred

• Possession of CCM or other healthcare certifications is preferred

• Experience using Epic or other EHR systems is preferred

🏝️ Benefits

• Medical, dental & vision coverage

• Critical Illness, Accident, and Hospital insurance

• 401(k) Retirement Plan with options for Pre-tax and Roth post-tax contributions

• Life Insurance (Voluntary Life & AD&D for employees and dependents)

• Short-term and long-term disability insurance

• Health Spending Account (HSA)

• Transportation benefits

• Employee Assistance Program

• Paid Time Off/Leave (PTO, Vacation, or Sick Leave)

• Fully remote work schedule

• Significant opportunities for growth

• Supportive and collaborative team environment