Registered Nurse Care Manager-Health Plan Admin Job at Christus Health, Irving, TX

L2M4QWhUYlFFZkNSTXB2RVZ6ZEkxSHd4aUE9PQ==
  • Christus Health
  • Irving, TX

Job Description

Description Summary: The RN Care Manager (CM) II works with physicians and multidisciplinary team members to develop a plan of care for each assigned patient from admission through discharge. The CM ensures that the patient is progressing toward desired outcomes by continuously monitoring patient care through assessments and/or evaluations. Assesses and responds to patient/family needs by coordinating efforts of other team members. Identifies and resolves barriers that hinder effective patient care. The CM plans effectively to meet patient need, manage length of stay and promote efficient utilization of resources to include the facilitation of patient care across the continuum, intervening as necessary to remove barriers to timely and efficient care delivery and reimbursement and resolves barriers that hinder effective patient care. Responsibilities:

Meets expectations of the applicable OneCHRISTUS Competencies: Leader of Self, Leader of Others, or Leader of Leaders. Coordinates/facilitates patient care progression throughout the continuum. Implements and monitors the patient’s plan of care to ensure effectiveness and appropriateness of services. Identifies and escalates system barriers that are impeding diagnostic or treatment progress. Proactively identifies and resolves delays and obstacles to discharge. Uses advances conflict resolution skills as necessary to ensure timely resolution of issues. Collaborates with medical staff, nursing staff, and ancillary staff to eliminate barriers to efficient delivery of care in the appropriate setting. Ensures that all elements critical to the plan of care have been communicated to the patient/family and members of the healthcare team and are documented as necessary to assure continuity of care. Manages all aspects of discharge planning for assigned patients. Provide appropriate interventions which demonstrate knowledge of and sensitivity toward cultural diversity and the religious, developmental, health literacy, and educational backgrounds of the patient population. Assesses the patient’s formal and informal support system as well as available benefits and/or community resources. Meets directly with patient/family to assess needs and develop and individualized care plan in collaboration with the physician. Ensures and maintains plan consensus from patient/family, physician and payor. Provide education, information, direction, and support related to patient’s goals of care. Acts as patient advocate to develop treatment plan and coordinate patient care and to transition patient to the appropriate next level of care. Demonstrates and promotes respect for the dignity and rights of every patient while adhering to the safety standards and practices of the organization and the nursing profession. Collaborates with the physician and other health care professionals to promote appropriate use of medical center resources. Provides information and support to patients and families, helping them access needed resources within the medical center and community. Actively participates in clinical performance improvement activities involving length of stay, resource utilization, avoidable days, cost per case, and readmissions. Measures effectiveness of interventions through direct communication with post-acute care providers, patients, and caregivers. Promotes individual professional growth and development by meeting requirements for mandatory/continuing education and skills competency. Job Requirements:

Education/Skills BSN Degree from an accredited nursing program or demonstrated success in CHRISTUS RN Care Manager I position required. Master’s degree in nursing preferred. Program management experience, including management of multiple projects at one time preferred. Excellent verbal and written communication. Critical and analytical thinking skills. Demonstrated clinical competency. Working knowledge of discharge planning, utilization management, case management, performance improvement, and managed care reimbursement. Understanding of pre-acute and post-acute levels of care and community resources. Ability to work independently and exercise sound judgment in interactions with physicians, payors, patients, and their families. Experience Three or more years clinical experience in clinical practice or demonstrated success in CHRISTUS RN Care Manager I position. Case management and Utilization Review experience preferred. Licenses, Registrations, or Certifications RN License in state of employment or compact required. Certification in Case Management or demonstrated success in CHRISTUS RN Care Manager I Position preferred. Work Type:

Full Time

Job Tags

Full time,

Similar Jobs

Anzen Health

Travel Occupational Therapist - Paying up to $2,597/week Job at Anzen Health

We are seeking a dedicated Travel Occupational Therapist to join our team in Santa Maria, CA. Responsibilities include evaluating patient needs, developing and implementing personalized treatment plans, and providing therapy to improve daily living skills. Must collaborate... 

CRH

Regional Lab Technician Job at CRH

 ...High School diploma or GED or equivalent Vocational Training/Certification, other related experience or combination Familiar with lab equipment Strong working knowledge of ASTM requirements used in testing concrete, mortars and concrete repair products Excellent... 

Beths Beautiful Destinations

Home-Based Travel Agent-Entry Level Job at Beths Beautiful Destinations

 ...This is a remote position. Home-Based Travel Agent-Entry Level Are you passionate about travel and looking for an exciting opportunity...  ..., and meet deadlines. Tech-Savvy: Comfortable using online platforms and booking engines to manage travel arrangements.... 

Aramark

2nd Shift Custodial Services Worker - Samsung Plano Texas Job at Aramark

Job Description Are you self-motivated and proud of the work you do? Here at Aramark, we take pride in our level of service and safety we provide! Cleanliness is a necessity of every business. As a Custodial Services worker on our team, youll take on the important...

State of Illinois

Criminal Justice Specialist I/ Grant Specialist - VOCA/VAWA Job at State of Illinois

 ...Job Requisition ID:52187 Opening Date: 12/15/2025 Closing Date: 12/30/2025Agency: Criminal Justice Information Authority Class Title: CRIM JUSTICE SPEC I - 10231 Skill Option: None Bilingual Option: None Salary: Anticipated starting salary $...