Enter a job title or keyword
Care Manager RN (Bilingual Spanish Preferred)
Job Location:
Job Location:
Houston, TX - USA
Yearly Salary:
USD 80000 - 94000
Yearly Salary:
Posted:
10 July 2026 (30+ days ago)
Posted:
Application Deadline:
18 November 2026
Application Deadline:
Vacancies:
1 Vacancy
Vacancies:
Job Summary
We are looking for a compassionate and experienced Care Manager - RN to join our Houston this role you will provide comprehensive care management and coordination for members across the continuum of care partnering with providers interdisciplinary teams and community resources to improve clinical outcomes enhance quality of care and support members with complex medical behavioral and psychosocial needs.
Our Values:
Our Values:
- Put Patients First
- Empower Entrepreneurial Provider and Care Teams
- Operate with Integrity & Excellence
- Be Innovative
- Work As One Team
What Youll Do
Care Management & Coordination
- Conduct comprehensive health assessments including medical behavioral and social determinants of health (SDOH).
- Develop implement and evaluate individualized care plans based on member needs goals and risk level.
- Coordinate care across multiple settings including inpatient outpatient and community-based services.
- Facilitate transitions of care including hospital discharge planning and post-discharge follow-up.
Clinical Oversight
- Utilize clinical expertise to identify gaps in care potential risks and opportunities for early intervention.
- Monitor member progress and adjust care plans accordingly.
- Provide education to members and caregivers regarding disease management medications and treatment plans.
- Apply evidence-based guidelines and best practices in care management.
Utilization Management & Cost Containment
- Support appropriate utilization of healthcare services to ensure cost-effective care delivery.
- Collaborate with utilization management teams to reduce avoidable hospitalizations and emergency department visits.
- Identify high-risk members and implement strategies to improve outcomes and reduce healthcare costs.
Collaboration & Communication
- Partner with physicians specialists behavioral health providers and community agencies to coordinate care.
- Serve as a liaison between members providers and health plan resources. Participate in interdisciplinary team meetings and case conferences. Maintain effective communication to ensure continuity of care.
Quality & Compliance
- Ensure timely and accurate documentation in accordance with regulatory CMS and organizational requirements.
- Support quality improvement initiatives including HEDIS STAR ratings and other performance measures.
- Maintain compliance with accreditation standards and internal policies.
- Member Engagement Conduct outreach to engage members in care management programs.
- Promote self-management and adherence to treatment plans.
- Address barriers to care including social economic and cultural factors.
Qualifications
- Bachelor of Science in Nursing (BSN) preferred; Associate degree in Nursing required
- Texas RN unrestricted active license
- At least 2 years of clinical nursing experience (case management acute care medical group health plan or managed care preferred)
- Certifications & Licensure Active unrestricted Registered Nurse (RN) license
- Strong clinical background must be familiar with developing care plans and assessments
- Experience with Microsoft Office Word
- Understanding of regulatory standards (CMS NCQA etc.).
- Ability to assess and manage complex clinical and psychosocial situations
- Excellent communication collaboration and critical-thinking skills
- Proficiency in electronic health records (EHR) and care management documentation systems
- Ability to manage multiple priorities in a fast-paced environment
Youll be a great for the role if:
- Bilingual proficiency in Spanish/English strongly preferred
- Able to work independently and make independent decisions
- Ability to work prioritize and multi-task
- Excellent written and verbal communication skills
- Maintain courteous professional attitude when working with internal and external customers
- Maintains member confidence and protects operations by keeping claim information confidential in compliance with HIPAA requirements
Environmental Job Requirements and Working Conditions
- This role follows a hybrid work structure where the expectation is to work on the field and at home on a weekly basis. The office is located at 19500 HWY 249 Suite 570 Houston TX 77070.
- This position requires up occasional travel for onsite visits or team meetings.
- The target pay range for this role is between $80000 - $94000 annually. Actual compensation will be determined based on geographic location (current or future) experience and other job-related factors.
Astrana Health is proud to be an Equal Employment Opportunity and Affirmative Action employer. We do not discriminate based on race religion color national origin gender (including pregnancy childbirth or related medical conditions) sexual orientation gender identity gender expression age status as a protected veteran status as an individual with a disability or other applicable legally protected characteristics. All employment is decided based on qualifications merit and business need. If you require assistance in applying for open positions due to a disability please email us at to request an accommodation.
Additional Information:
The job description does not constitute an employment agreement between the employer and employee and is subject to change by the employer as the needs of the employer and requirements of the job change.
Additional Information:
The job description does not constitute an employment agreement between the employer and employee and is subject to change by the employer as the needs of the employer and requirements of the job change.
Required Experience:
Manager
