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RN Case Manager

Location : Houston, TX
Job Type : Contract
Reference Code : 16526
Hours : Full Time
Required Years of Experience : 2
Travel : No
Relocation : No
Job Industry : Healthcare - Health Services
Job Category : Healthcare - RNs & Nurse Management

Job Description :

We have an awesome client in Houston, TX who is in need of RN's to fulfill their Case Manager needs! For these positions you must live in Houston, TX or nearby to qualify ! These are remote positions for now!

Case Manager l Job Responsibilities:

Works with the Utilization Management team primarily responsible for inpatient medical necessity/utilization review and other utilization management activities aimed at providing members with the right care at the right place at the right time. Provides daily review and evaluation of members that require hospitalization and/or procedures providing prior authorizations and/or concurrent review.

Day to day responsibilities include: • Completes comprehensive assessments of members per regulated timelines and determines who may qualify for case management based on clinical judgment, changes in member's health or psychosocial wellness, and triggers identified in the assessment. • Develops and implements a case management plan in collaboration with the member, caregiver, physician and/or other appropriate healthcare professionals and member's support network to address the member needs and goals. • Conducts face-to-face or home visits as required. • Performs ongoing monitoring of the care plan to evaluate effectiveness, document interventions and goal achievement, and suggest changes accordingly. • Maintains ongoing member case load for regular outreach and management. • Promotes integration of services for members including behavioral health care and long term services and supports/home and community to enhance the continuity of care for members. • Facilitates interdisciplinary care team meetings and informal ICT collaboration. • Uses motivational interviewing and clinical guideposts to educate, support and motivate change during member contacts. • Assesses for barriers to care, provides care coordination and assistance to member to address concerns. • . • RNs provide consultation, recommendations and education as appropriate to non-RN case managers. • RNs are assigned cases with members who have complex medical conditions and medication regimens • RNs conduct medication reconciliation when needed.

Case Manager lI Job Requirements:

    • Completion of an accredited Registered Nursing program. (a combination of experience and education will be considered in lieu of Registered Nursing degree).

For immediate consideration please email sroper@mednational

Required Qualifications :
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