Nurse Case Manager: Care Coordination & Outcomes

TRIUNE Health Group; Texas; Hybrid; USD 65,000 - 90,000; Full time

Benefits offered by this job

Time Off

401(k) Match

Medical, dental, and vision

Disability Insurance

Employee Assistance Program

Home office equipment

Travel reimbursement

Job summary

TRIUNE Health Group is seeking a Nurse Case Manager to coordinate resources and develop flexible, cost-effective treatment options for catastrophically or chronically ill or injured individuals, facilitating timely return to work where appropriate.

The role requires evaluating medical necessity, coordinating with healthcare providers, employers, and referral sources, and ensuring compliant communication under HIPAA and workers’ compensation laws.

Qualifications

• Graduate of an accredited school of nursing.
• Current RN licensure in the state of operation.
• CCM preferred.

Responsibilities

• Provide medical case management coordinating with patient, physicians, healthcare providers, employer, and referral source.
• Coordinate assessment, planning, implementation, evaluation, and outcomes of patient progress.
• Evaluate treatment plans for appropriateness, medical necessity, and cost-effectiveness.
• Facilitate care delivery, including durable medical equipment and home health services coordination.
• Assess rehabilitation facility suitability and coordinate transportation and home assessments as needed.
• Communicate medical information clearly to patients and families.

Job description

TRIUNE Health Group is seeking a Nurse Case Manager to coordinate resources and develop flexible, cost-effective treatment options for catastrophically or chronically ill or injured individuals, facilitating timely return to work where appropriate.

The role requires evaluating medical necessity, coordinating with healthcare providers, employers, and referral sources, and ensuring compliant communication under HIPAA and workers’ compensation laws.