RN Complex Case Manager: Chronic Care Navigator

Harris Health; Houston (TX); On-site; USD 65,000 - 90,000; Full time

Job summary

Community Health Choice, Inc. in Houston seeks a Complex Case Manager to identify and coordinate care for members with chronic, medically complex conditions in acute and non-acute settings.

You will conduct telephonic assessments, build individualized plans, and authorize services to maximize outcomes. The role requires RN licensure in Texas (BSN preferred) and several years of acute care and managed care experience, with strong communication and analytical skills.

Qualifications

• RN with Texas license; CCM requires or to be obtained within 18 months.
• 5 years clinical experience in acute care; 2 years in managed care/insurance preferred.
• Proficient with Microsoft Office (Word, Excel, Outlook).

Responsibilities

• Identify, monitor, and evaluate health service delivery for members with chronic or complex conditions.
• Coordinate care with PCPs, specialists, and other providers; perform telephonic assessments and plan care.
• Authorize services across levels of care and ensure proper data entry in the case management system.
• Refer to community health workers and disease management teams; support case management metrics.

Skills

Communication skills

Analytical thinking

Medical terminology

Public contact

Education

Registered Nurse (RN) license in TX

BSN preferred

Tools

Microsoft Office

MS Word

Job description

Community Health Choice, Inc. in Houston seeks a Complex Case Manager to identify and coordinate care for members with chronic, medically complex conditions in acute and non-acute settings.

You will conduct telephonic assessments, build individualized plans, and authorize services to maximize outcomes. The role requires RN licensure in Texas (BSN preferred) and several years of acute care and managed care experience, with strong communication and analytical skills.