Case Manager II

ID: 644467
Type: Contract
Location: Edinburg, TX
Contact Email:
Salary: Open
Our client is currently seeking a Case Manager RN to join their team in the Edinburg, TX area.

This job will have the following responsibilities:
  • Provides case management services to members with chronic or complex conditions including: 
    • Proactively identifies members that may qualify for potential case management services.
    • Conducts assessment of member needs by collecting in-depth information from internal information system, the member, members family/caregiver, hospital staff, physicians and other providers. 
    • Identifies, assesses and manages members per established criteria. 
    • Develops and implements a case management plan in collaboration with the member, caregiver, physician and/or other appropriate healthcare professionals to address the member needs. 
    • Performs ongoing monitoring of the plan of care to evaluate effectiveness.
    • Documents care plan progress in the internal information system. 
    • Evaluates effectiveness of the care plan and modifies as appropriate to reach optimal outcomes. 
    • Measures the effectiveness of interventions to determine case management outcomes.
  • Conducts face to face or home visits as required. 
  • Maintains department productivity and quality measures.
  • Manages and completes assigned work plan objectives and projects in a timely manner.

Qualifications & Requirements:
  • Bachelor's degree in Nursing (a combination of experience and education will be considered in lieu of degree)
  • 2-4 years of clinical experience with case management experience.
  • Active, unrestricted State Registered Nursing license in good standing.
  • Demonstrated ability to communicate, problem solve, and work effectively with people. 
  • Excellent organizational skill with the ability to manage multiple priorities. 
  • Work independently and handle multiple projects simultaneously. 
  • Strong analytical skills. 
  • Knowledge of applicable state, and federal regulations. 
  • Knowledge of ICD-9, CPT coding and HCPC.

If this is a position that is of interest to you please email me your most up to date resume and a good time to call to or reach out to (720) 463-3586
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