Case Manager II (RN) Lubbock

***FULLY REMOTE POSITION IN LUBBOCK AREA***

Job Description: 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.

Responsibilities of this the role or description of the project:

• Complete in-home assessment which includes:
• SAI Core A to Core Q
• ISP
• EDP
• Other forms as applicable: 1500 forms, SBP, EVV
• Assessing the member’s current health status, resource utilization, past and present treatment plan and services, short- and long-term goals, treatment and provider options.
• Follow up on requests for items/services
• Speaking to providers

Describe the performance expectations/metrics for this individual and their team:

• Complete 6 successful visits per week
• Submit assessment within 24 hours of visit
• Submit all other documentation within 5 BD
• Visits are typically M-F 8-5; however, due to contractual requirements, assessments and documentation do require to be turned in within turnaround times/compliance
• Due to pediatric population some visits are 3pm or after, we get request for Saturday visits at times
• Visits are completed in the home setting, travel to members home is necessary.
• Travelling may be 100 + mile radius.

Preferred counties are:

Hockley, Lubbock, Crosby, Terry, Lynn, Garza, Lamb, Hale, and Floyd

• Visits will be within the Lubbock Service Delivery Area which includes counties from Hutchinson to Terry, Lynn, and Garza
• Visits may include surrounding counties
• Travel time will be taken into consideration and may modify productivity for that week.

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.

Licenses/Certifications: TX RN license.