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Superior HealthPlan
Austin, TX, United States
Job Description: You could be the one who changes everything for our 28 million members as a clinical professional on our Medical Management/Health Services team. Centene is a diversified, national organization offering competitive benefits including a fresh perspective on workplace flexibility. Must be licensed and reside in Texas Hybrid Position
Job Source: Superior HealthPlanSunshine Health
Austin, TX, United States
Care Manager RN - Pediatrics page is loaded Care Manager RN - Pediatrics Apply locations Austin-5900 E Ben White Blvd (10703) time type Full time posted on Posted 2 Days Ago job requisition id 1485236 You could be the one who changes everything for our 28 million members as a clinical professio
Job Source: Sunshine HealthAscension Seton Northwest
austin
RN Registered Nurse - Pediatric Acute Care Details * Sign-on bonus: $10,000.00. * Department: Pediatric Acute Care * Schedule: Part Time Nights - 6:45pm-7:15am. Weekend and minimum 2 major holidays per year. Float between Dell Children's Medical Center and North hospital * Hospital: Ascension North Children's Hospital * Location: Austin, TX Benef
Job Source: Ascension Seton NorthwestAscension Seton Northwest
austin
RN Clinic Manager - Pediatric Neurosciences Details * Department: Pediatric Neurosciences * Schedule: Monday - Friday 8:00a - 5:00p * Hospital: Dell Children's Special Pavilion * Location: 4910 Mueller Blvd Austin Suite 300, Texas 78723 Benefits Paid time off (PTO) Various health insurance options & wellness plans Retirement benefits including
Job Source: Ascension Seton NorthwestAscension Seton Northwest
austin
RN Registered Nurse - Pediatric Respiratory Acute Care Details * Sign-on bonus: $20,000 * Department: Pediatric Respiratory Acute Care * Schedule: Full-Time Night 7pm - 7am. Some weekend and holidays. * Hospital: Dell Children's Medical Center * Location: Austin, TX Benefits Paid time off (PTO) Various health insurance options & wellness plans
Job Source: Ascension Seton NorthwestBaylor Scott & White Health
Austin, TX, United States
About Us At Baylor Scott & White Health, we promote well-being for everyone. It's the largest nonprofit healthcare system in Texas, empowering a healthy lifestyle. Our Core Values are: We serve faithfully by doing what's right with a joyful heart. We never settle by constantly striving for better. We are in it together by supporting one anothe
Job Source: Baylor Scott & White HealthBaylor Scott & White Health
Pflugerville, TX, United States
BSW ROUND ROCK MEDICAL CENTER EXPANSION 2025 Join us in an extraordinary opportunity to be at the forefront of our hospital's expansion in Round Rock, Texas. As we gear up to open our doors on January 11, 2025, you'll play a pivotal role in shaping the future of healthcare in our community. Our expansion, spanning 165,000 square feet, will introduc
Job Source: Baylor Scott & White HealthBaylor Scott & White Health
Lakeway, TX, United States
About Us At Baylor Scott & White Health, we promote well-being for everyone. It's the largest nonprofit healthcare system in Texas, empowering a healthy lifestyle. Our Core Values are: We serve faithfully by doing what's right with a joyful heart. We never settle by constantly striving for better. We are in it together by supporting one another and
Job Source: Baylor Scott & White HealthAustin, TX, United States
You could be the one who changes everything for our 28 million members as a clinical professional on our Medical Management/Health Services team. Centene is a diversified, national organization offering competitive benefits including a fresh perspective on workplace flexibility.
Must be licensed and reside in Texas
Hybrid Position - SDA Travis County
Position Purpose: Perform care management duties to assess, plan and coordinate all aspects of medical and supporting services across the continuum of care for select members to promote quality, cost effective care.
Assess the member's current health status, resource utilization, past and present treatment plan and services, prognosis, short and long term goals, treatment and provider options
Utilize assessment skills and discretionary judgment to develop plan of care based upon assessment with specific objectives, goals and interventions designed to meet member's needs and promote desired outcomes
Coordinate services between Primary Care Physician (PCP), specialists, medical providers, and non-medical staff as necessary to meet the complete medical socio economic needs of clients
Provide patient and provider education
Facilitate member access to community based services
Monitor referrals made to community based organizations, medical care and other services to support the members’ overall care management plan
Actively participate in integrated team care management rounds
Identify related risk management quality concerns and report these scenarios to the appropriate resources.
Case load will reflect heavier weighting of complex cases than Care Manager I, commensurate with experience
Enter and maintain assessments, authorizations, and pertinent clinical information into various medical management systems
Direct care to participating network providers
Perform duties independently, demonstrating advanced understanding of complex care management principles.
Participate in case management committees and work on special projects related to case management as needed
Each position will be the delegated agency’s single point of contact to coordinate the overall CM activities provided to the target population
Review and approve the initial and ongoing assessment and care plan to ensure requirements are met
Coordinate service request/authorizations with UM and ensure agreement is aligned between the member, agency, and MCO
Facilitate member linkages to MCO-based services and programs in collaboration w/ agency staff
Assist members and/or agency staff w/ transportation to healthcare appointments
Communicate status of member health indicators with agency staff that can contribute the successful community living of members
Participate in weekly rounds w/ agency staff
Other duties as assigned
Education/Experience: Graduate from an Accredited School of Nursing. Bachelor’s degree in Nursing preferred. 2+ years of clinical nursing experience in a clinical, acute care, or community setting and 1+ years of case management experience in a managed care setting. Knowledge of utilization management principles and healthcare managed care. Experience with medical decision support tools (i.e. Interqual, NCCN) and government sponsored managed care programs.
Licenses/Certifications: Current state’s RN license.
Texas Requirements:
Education/Experience: Graduate from an Accredited School of Nursing. Bachelor’s degree in Nursing preferred. 2+ years of clinical nursing or case management experience in a clinical, acute care, managed care or community setting. 2+ years experience working with people with disabilities and vulnerable populations who have chronic or complex conditions in a managed care environment. Experience with medical decision support tools (i.e. Interqual, NCCN) and government sponsored managed care programs. Other state specific requirements may apply.
Pay Range: $66,100.00 - $118,900.00 per year
Our Comprehensive Benefits Package: Flexible work solutions including remote options, hybrid work schedules and dress flexibility, Competitive pay, Paid time off including holidays, Health insurance coverage for you and your dependents, 401(k) and stock purchase plans, Tuition reimbursement and best-in-class training and development.
Centene offers a comprehensive benefits package including: competitive pay, health insurance, 401K and stock purchase plans, tuition reimbursement, paid time off plus holidays, and a flexible approach to work with remote, hybrid, field or office work schedules. Actual pay will be adjusted based on an individual's skills, experience, education, and other job-related factors permitted by law. Total compensation may also include additional forms of incentives.
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Care Manager RN - Pediatrics jobs in Austin, TX, United States
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Get ready to discover your next great opportunity.