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RN, Case Manager/HP (OB Maternity)

Key Facts

Remote From: 
Category:  Case Manager
Full time
Mid-level (2-5 years)
Spanish, English

Other Skills

  • β€’
    Quality Assurance
  • β€’
    Microsoft Office
  • β€’
    Organizational Skills
  • β€’
    Social Skills
  • β€’
    Non-Verbal Communication
  • β€’
    Adaptability

Roles & Responsibilities

  • Associates Degree in Nursing, BSN preferred
  • Three years or more of case management experience
  • Experience with high-risk OB/Maternity/Postpartum population preferred
  • Current RN license from Texas Board of Nursing required

Requirements:

  • Provide telephonic case management services to OB High-Risk Maternity, Postpartum population
  • Identify and coordinate short and long-term needs for assigned member population
  • Perform case management activities across the continuum of care
  • Promote and facilitate quality, cost-effective outcomes

Job description

Location:

Calmont Operations Building

Department:

STAR/CHIP CM

Shift:

First Shift (United States of America)

Standard Weekly Hours:

40

Summary:

Additional Information:

The RN Case Manager will provide telephonic case management services to the OB High-Risk Maternity, Postpartum population of Cook Health plan members. The RN will identify and coordinate short and long-term needs and perform case management activities across the continuum of care in order to promote and facilitate quality, cost effective outcomes and minimize fragmentation of health care delivery for the assigned member population.Hours: Mon-Fri 8am-5pm, Remote position but will require some on-site training and on-site team meetings in Fort Worth.

Required Education and Experience:

  • Associates Degree in Nursing, BSN preferred.

  • Three (3) years or more of any combination of experience working in/with case management, care coordination, utilization review, patient intake, discharge planning and troubleshooting fund resources, quality assurance, clinical pathways, continuous quality improvement, or state and federal health plans or commercial insurance plans in a clinical or managed care environment.

  • Experience working with high-risk OB/Maternity/Postpartum population strongly preferred.

  • Strong Computer skills using all MS Office products and other platforms.

  • Requires effective organizational, interpersonal, written, and oral communication skills.

  • Must be familiar with various community resources and charitable organizations.

  • Must be able to adapt to changing healthcare environments and work with all members of the healthcare team to achieve positive outcomes.

  • Experience using or navigating electronic medical records (e.g., EPIC, Meditech, Healthy Planet, etc.).

  • Bilingual (English/Spanish) preferred.

Licensure, Registration, and/or Certification:

  • Current RN license from Texas Board of Nursing required

  • Case Manager Certification (CCM) preferred.

About Us:

Cook Children's Health Plan

Cook Children's Health Plan provides vital coverage to nearly 120,000 people in low-income families who qualify for government-sponsored programs in our six county service region.  Cook Children's Health Plan provides health coverage for CHIP, CHIP Perinatal, STAR (Medicaid) and STAR Kids Members in the Tarrant county service area. The counties we serve includes Tarrant, Johnson, Denton, Parker, Hood and Wise.

Cook Children’s is an equal opportunity employer. As such, Cook Children’s offers equal employment opportunities without regard to race, color, religion, sex, age, national origin, physical or mental disability, pregnancy, protected veteran status, genetic information, or any other protected class in accordance with applicable federal laws. These opportunities include terms, conditions and privileges of employment, including but not limited to hiring, job placement, training, compensation, discipline, advancement and termination.

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