Remote TX RN Care Manager — Complex Care Management

Universal Health Services, Inc.; McAllen (TX); On-site; USD 75,000 - 105,000; Full time

Benefits offered by this job

Loan Forgiveness Program

Competitive Compensation & Generous PT

Excellent Medical, Dental, Vision and

401(K) with company match

SoFi Student Loan Refinancing Program

Career development opportunities

Job summary

Prominence Health is seeking an RN Care Manager to provide care management services for medically and/or socially complex members. You will develop individualized care plans, coach for adherence, and promote the Care Management program to contracted physicians and members.

Under supervision, you will ensure the SNP CM program aligns with CMS, Medicaid, and NCQA requirements, while collaborating with community resources and support agencies. Remote in TX is supported.

Qualifications

• Associate or Bachelor’s Degree in Nursing, required.

Responsibilities

• Provide care management services for medically and/or socially complex members.
• Develop comprehensive care plans for member and family self-care.
• Promote the Care Management program to Prominence Health Plan contracted physicians and members.
• Support SNP CM program implementation and ensure CMS/Medicaid/NCQA compliance.

Skills

Bilingual Spanish/English

Communication skills

Care management knowledge

Education

Nursing degree (Assoc or BSN)

Job description

Prominence Health is seeking an RN Care Manager to provide care management services for medically and/or socially complex members. You will develop individualized care plans, coach for adherence, and promote the Care Management program to contracted physicians and members.

Under supervision, you will ensure the SNP CM program aligns with CMS, Medicaid, and NCQA requirements, while collaborating with community resources and support agencies. Remote in TX is supported.