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Bilingual Pediatric Intensive Case Manager (RN) - Pediatrics

Company: Nursing Solutions
Location: Sherman
Posted on: September 13, 2023

Job Description:

Bilingual Pediatric Intensive Case Manager (RN)Summary of Position: The RN Case Manager for AOC's Intensive Case Management Services team, will be directly supporting AOC's highest risk Star Kids clients. In collaboration with other members of the healthcare team, the RN Care Manager is responsible for organizing, coordinating, and providing care coordination and care management services to clients who are most at risk for utilization of hospitals, emergency rooms and urgent care centers. The RN Care Manager is responsible for assessing and coordinating client care across the continuum, utilizing accepted criteria and guidelines to manage Medicaid services and community resources. This position will function as a clinician, case manager, and educator to achieve optimal clinical and quality outcomes by effectively managing care and resources to reduce unnecessary utilization of inpatient and outpatient services.

Pay Range: $60,000 - $70,000 based on experience

Essential Duties and Responsibilities (Other duties may be assigned):

* Work collaboratively with patients, families, physicians and AOC staff to ensure high quality care for high risk clients.
* Work with members of the client's care team to identify trends and manage re-emerging needs.
* Coordinate with hospitals and Managed Care Organizations (MCO) during hospital admissions and hospital discharge planning to ensure all referrals for services are in place.
* Assist with scheduling follow-up physician appointments for clients as needed and provide routine check-ins to ensure client/family is attending physician appointments.
* Communicate client needs with AOC teams including Acute Triage teams and Clinical Care Managers (CCM's) on all aspects of client's care needs.
* Provide frequent and ongoing communication with the client and family to identify needs and escalate to the appropriate care teams.
* Researches, evaluates and recommends resources to meet medical and non-medical needs of clients and families. Collaborates, refers and communicates across all programs to ensure appropriate coordination of services.
* Act as the patient's advocate
* Maintain the patient's comprehensive clinical record through detailed documentation in the EMR
* Manage a caseload of clients who have been identified for care management
* Develop trust and build rapport with a selected AOC clients/families
* Develop relationships with the care coordination teams, physicians, and clinic staff
* Maintain a courteous and helpful manner when working with patients, physicians, and associates
* Establishes client care management plans, interventions, treatment goals and self-management goals.
* Assists client/families with self-management through education, visits and telephonic engagement; encourages and supports patient adherence to their care plans.
* Review patient non-compliance issues and conduct outreach to close them
* Participate in special projects and perform other duties as assigned by supervisor.

Supervisory Responsibilities: None

Performance Responsibilities: The following listing applies to every employee.

All employees of the organization:

* Exercise necessary cost control measures.
* Maintain positive internal and external customer service relationships.
* Demonstrate effective leadership skills.
* Demonstrate effective communication skills by conveying necessary information accurately, listening effectively and asking questions when clarification is needed.
* Be depended upon to plan and organize work effectively and ensure its completion.
* Meet all productivity requirements.
* Demonstrate team behavior and must be willing to promote a team-oriented environment.
* Represent the organization professionally at all times.
* Demonstrate initiative
* Continually improve processes and relationships.


* License: Registered Nurse (BSN preferred, ADN considered)
* Certification: BLS, PALS preferred; CCMC preferred
* Minimum of 2 years Case Management experience in home health or hospital case management, pediatric case management experience preferred
* Minimum of 5+ years of clinical experience in a pediatric ambulatory care or inpatient setting
* Bilingual

Abilities, Skills, and Knowledge:

* Knowledge of case management, resource and utilization management for StarKids population
* Skilled in case management and patient assessments.
* Excellent verbal and written communication skills required.
* Ability to monitor, assess and record patient progress against a plan of care.
* Ability to facilitate patient access to community resources.
* Ability to work collaboratively with both internal and external medical staff and external partners and organizations.
* Ability to assess, adapt, and calmly respond to changing and crisis environment.
* Ability to maintain confidentiality with all aspects of client information in accordance with all applicable policies and regulations.

Physical Requirements:

* Sitting for extended periods of time.
* Dexterity of hands and fingers to operate a computer keyboard, mouse, and to handle other computer components.
* Physically able to participate in training sessions, presentations, and meetings.
* Excellent verbal and written communication, hearing and visual acuity and color distinction.
* The nurse must sit in front of a computer screen for prolonged periods of time.

Work Environment:

* The RN Case Manager will be assigned a workstation with equipment in a regular office environment or a home office/remote office environment.

Keywords: Nursing Solutions, McKinney , Bilingual Pediatric Intensive Case Manager (RN) - Pediatrics, Other , Sherman, Texas

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