RN: Clinical Utilization & Care Coordination

University Health Careers; Pleasanton (TX); On-site; USD 75,000 - 95,000; Full time

Job summary

Community First Health Plan (CFHP) is seeking an experienced Registered Nurse to oversee care coordination and resource allocation for members in Texas. The role includes coordinating care across the health care continuum and collaborating with multi-disciplinary teams to optimize outcomes.

The ideal candidate holds an RN license in Texas, a BSN or MSN is preferred, and a minimum of three years in nursing, acute care, quality management, or managed care is required.

Qualifications

• RN licensure in Texas is required.
• Bachelor of Science in Nursing (BSN) or Master’s degree preferred.
• Minimum 3 years nursing acute care, quality management or managed care experience.

Responsibilities

• Oversee allocation of resources, cost and quality of care for members.
• Coordinate care between primary care physicians, community resources, family and member.
• Collaborate with multi-disciplinary health care team to identify educational and discharge needs.

Skills

Care coordination

Quality management

Team collaboration

Communication

Education

BSN

MSN

Tools

InterQual

Job description

Community First Health Plan (CFHP) is seeking an experienced Registered Nurse to oversee care coordination and resource allocation for members in Texas. The role includes coordinating care across the health care continuum and collaborating with multi-disciplinary teams to optimize outcomes.

The ideal candidate holds an RN license in Texas, a BSN or MSN is preferred, and a minimum of three years in nursing, acute care, quality management, or managed care is required.