RN Care Manager - Complex Care & Transitions

CareMore Health Management Services, LLC; Cedar Park (TX); On-site; USD 54,000 - 97,000; Full time

Job summary

CareMore Health Management Services, LLC is seeking a Clinical Case Manager, RN to manage a caseload of patients with complex or chronic conditions, applying RN-level clinical judgment to assess needs and coordinate care plans.

You will lead care coordination across multidisciplinary teams, manage transitions including hospital discharge planning, and collaborate with payers on utilization management to support value-based contract performance.

Qualifications

• Must hold RN license and perform RN-level clinical judgment.
• Experience with care coordination and transitions in chronic conditions.
• Ability to work with multidisciplinary teams and payers for utilization management.

Responsibilities

• Conduct comprehensive clinical assessments for patients with complex medical, behavioral, and social needs, developing individualized care plans within RN scope of practice.
• Lead care coordination across multidisciplinary teams — including physicians, specialists, social workers, and community resources — to implement care plans and resolve barriers to care.
• Manage care transitions including hospital discharge planning, post-acute placement, and follow-up monitoring to reduce readmissions and ensure continuity.
• Apply clinical judgment to adjust care plans in response to changing patient conditions, escalating to physicians or supervising clinicians when appropriate.
• Collaborate with payers on utilization management activities, authorization requirements, and documentation to support value-based contract performance.
• Maintain accurate, timely case documentation and contribute to quality monitoring and reporting activities.

Job description

CareMore Health Management Services, LLC is seeking a Clinical Case Manager, RN to manage a caseload of patients with complex or chronic conditions, applying RN-level clinical judgment to assess needs and coordinate care plans.

You will lead care coordination across multidisciplinary teams, manage transitions including hospital discharge planning, and collaborate with payers on utilization management to support value-based contract performance.