Lead RN Case Manager

Nexus Health Systems; Saint George, Northern (LA, KY); Hybrid; USD 70,000 - 100,000; Full time

Job summary

The Nexus Children’s Hospital – Shenandoah is seeking a Lead RN Case Manager to join our pediatric-focused team in Shenandoah, TX. You will assess psychosocial needs, plan and coordinate care, and ensure cost-effective care across the episode while preventing fragmentation of services.

Collaborate with physicians, payors, and an interdisciplinary team to support age-specific outcomes, discharge planning, and resource management in a compassionate care environment.

Qualifications

• Current RN license in the State of Texas (required).
• BSN preferred.
• Case Management certification (ACM or CCM) preferred.
• Prior experience in pediatrics, rehabilitation, acute care, behavioral health, or complex medical case management strongly preferred.
• Strong communication skills and ability to work effectively with families under stress.

Responsibilities

• Maintains PHI and HIPAA compliance according to hospital policy and regulations.
• Promotes a safe working environment and safe patient care at all times.
• Practices "minimum information necessary" during utilization review, case management, and discharge functions.
• Acts as a patient advocate for all patients within the facility.
• Adheres to all regulatory, company, and ethical standards of practice.
• Demonstrates respect, professionalism, and confidentiality at all times.
• Supports and models the organization’s mission, vision, and values.
• Conducts initial and ongoing patient assessments with focus on clinical needs and discharge criteria.
• Plans, coordinates, and facilitates interdisciplinary care conferences.
• Evaluates ongoing treatment plans and collaborates with providers for adjustments.
• Coordinates discharge planning and ensures safe transition to the next level of care.
• Provides education to patients and families regarding treatment goals, discharge needs, and community resources.

Skills

RN licensure (TX)

Communication

Pediatrics experience

Utilization review

Discharge planning

Case management cert

Education

BSN preferred

Job description

If you are unable to complete this application due to a disability, contact this employer to ask for an accommodation or an alternative application process.

Lead RN Case Manager

Full Time Shenandoah, TX, US

30+ days ago Requisition ID: 2136

About Nexus Children’s Hospital – Shenandoah

Nexus Children’s Hospital – Shenandoah specializes in providing comprehensive, pediatric-focused care for children and adolescents with complex medical, neurological, and rehabilitative needs. Our interdisciplinary approach supports recovery, independence, and long-term quality of life through coordinated medical care, therapy services, and family engagement. We are committed to empowering patients and families throughout their healthcare journey with compassion, expertise, and a collaborative spirit.

Position Summary

The RN Case Manager is responsible for assessing patient and family psychosocial needs, planning and coordinating care, and evaluating clinical progress across the healthcare episode. This role ensures cost-effective care delivery within appropriate length of stay while preventing fragmentation of services. Working collaboratively with physicians, payors, and an interdisciplinary healthcare team, the RN Case Manager supports age-specific and patient-focused outcomes, linking resource management with quality care.

Job Responsibilities

General Responsibilities

• Maintains PHI and HIPAA compliance according to hospital policy and federal regulations.
• Promotes a safe working environment and safe patient care at all times.
• Practices "minimum information necessary" when performing utilization review, case management, and discharge functions.
• Acts as a patient advocate for all patients within the facility.
• Adheres to all regulatory, company, and ethical standards of practice.
• Demonstrates respect, professionalism, and confidentiality at all times.
• Supports and models the organization’s mission, vision, and values.

Case Management & Coordination

• Conducts initial and ongoing patient assessments, focusing on clinical needs, discharge criteria, and family support.
• Plans, coordinates, and facilitates interdisciplinary care conferences.
• Evaluates ongoing treatment plans and collaborates with providers for necessary adjustments.
• Prevents service duplication and ensures appropriate use of resources.
• Collaborates with third-party payors to provide medical information and support authorization processes.
• Coordinates discharge planning, ensuring safe and effective transition to the next level of care.

Patient & Family Engagement

• Serves as a primary communication point for patient families and outside agencies.
• Provides education regarding treatment goals, discharge needs, and community resources.
• Facilitates problem-solving and addresses barriers to discharge or care progression.

Qualifications

• Current RN license in the State of Texas (required)
• Bachelor of Science in Nursing preferred
• Case Management certification (ACM or CCM) preferred
• Prior experience in pediatrics, rehabilitation, acute care, behavioral health, or complex medical case management strongly preferred
• Strong communication skills and ability to work effectively with families under stress
• Experience with utilization review or managed care interaction is a plus

Why Join Nexus?

• Mission-driven pediatric and neuro-rehabilitation environment
• Collaborative and supportive interdisciplinary culture
• Opportunity to impact children and families facing complex healthcare challenges