Care Manager RN - Pediatrics

Job Description

We are looking for a Care Manager RN specializing in Pediatrics to join our Medical Management/Health Services team at Superior HealthPlan. As part of this role, you will perform care management duties to assess, plan, and coordinate medical and supporting services for select members, ensuring quality and cost-effective care.

Responsibilities

• Assess the health status, resource utilization, and treatment plan of members.
• Develop care plans with specific objectives and interventions.
• Coordinate services between healthcare providers to meet members' needs.
• Provide patient and provider education.
• Facilitate access to community-based services.
• Monitor referrals and participate in care management rounds.
• Enter and maintain clinical information in medical management systems.
• Collaborate with case management committees and work on special projects.

Requirements

• Graduate from an Accredited School of Nursing.
• Bachelor’s degree in Nursing preferred.
• 2+ years of clinical nursing experience.
• 1+ years of case management experience in managed care.
• Current RN license in the state of Texas.
• Knowledge of utilization management principles and healthcare managed care.

Salary

Pay Range: $66,100.00 - $118,900.00 per year

Benefits

• Competitive pay.
• Health insurance.
• 401K and stock purchase plans.
• Tuition reimbursement.
• Paid time off plus holidays.
• Flexible work schedules.