Case Manager- Population Health
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Job Location:
Houston, MS - USA
Monthly Salary:
Not Disclosed
Posted on:
3 hours ago
Vacancies:
1 Vacancy
Job Summary
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 individuals health needs. Provides comprehensive ongoing case management services to Texas Childrens 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/members family in coping with illness by optimizing the members/familys self-care abilities and supporting their consumer rights.
Think youve got what it takes
Qualifications:
- Diploma in Nursing OR an Associates degree Nursing or an associates degree in a related field accepted by the Texas Board of Nursing for the purposes of obtaining and maintaining an RN license OR Bachelors 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 members 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 members 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.
Required Experience:
Manager
Key Skills
- Project Portfolio Management
- Motivational Interviewing
- HIPAA
- Computer Skills
- Intake Experience
- Lean Six Sigma
- Conflict Management
- Case Management
- Team Management
- Program Development
- Social Work
- Addiction Counseling
About Company
Since 1954, Texas Children’s has been leading the charge in patient care, education and research to accelerate health care for children and women around the world. When you love what you do, it truly shows in the smiles of our patient families, employees and our numerous accolades suc ... View more
