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RN Case Manager
Location
Texas
Posted
23 days ago
Salary
0
Seniority
Senior
Job Description
RN Case Manager
GuideWell Source
• Case Management process includes assessing the member’s health status and care coordination needs. • Contact with patient, family, physicians, additional health care providers, and community resources. • Identification of alternative treatment plans, which would have to be approved by all parties. • Assessment of the clinical status and resultant sequela to coordinate the most appropriate service to meet the individual’s health care needs. • Identification of services, resources, providers, and facilities that could best serve members in a timely and cost-effective manner. • Development and implementation of Case Management goals, both short and long term, with documented care plans. • Utilize technology/resources to evaluate the cost-effectiveness of the elected treatment plan. • Accurate and timely reporting as deemed appropriate by each client member. • Medical record review to determine medical necessity of requested services. • Interpreting individual health plans and authorizing/coordinating care in accordance with plan provisions.
Job Requirements
- 5+ years related work experience with a professional background in clinical nursing and patient assessment.
- Related Bachelor’s degree or additional related equivalent work experience
- Graduate of an accredited school of nursing
- RN - Registered Nurse - State Licensure
- Compact State Licensure in good standing.
- Knowledgeable in medical terminology, reasonable and necessary treatment plans, delivery quality health care services and cost containment practices.
- Ability to collaborate with cross-operational areas within the organization.
Benefits
- Medical, dental, vision, life and global travel health insurance
- Income protection benefits: life insurance, Short- and long-term disability programs
- Leave programs to support personal circumstances
- Retirement Savings Plan includes employer contribution and employer match
- Paid time off, volunteer time off, and 11 holidays
- Additional voluntary benefits available and a comprehensive wellness program
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