Nurse Case Manager

Medix is currently hiring for LVN/LPN Case Managers that will strictly telephonic/work from home. This role is with a Texas Health Plan working with the medicaid population. The Nurse Case Managers is responsible for overall management of non-HCBS (non-waiver) member's case within the scope of licensure;provides supervision and direction to non-RN clinicians participating in the member's case in accordance with applicable state law and contract; develops, monitors, evaluates, and revises the member's care plan to meet the member's needs, with the goal of optimizing member health care across the care continuum

Schedule - Monday - Friday (8a-5p)

Type - Remote but must live in the Houston area

Job Specifications

• Assess, plan, and implement care strategies that are individualized by member and directed toward the most appropriate, lease restrictive level of care.
• Identify and initiate referrals for social service programs, including financial, psychosocial, community and state supportive services.
• Manage the care plan throughout the continuum of care as a single point of contact.
• Communicate with all stakeholders the required health-related information to ensure quality coordinated care and services are provided expeditiously to all members.
• Advocate for patients and families as needed to ensure the patient's needs and choices are fully represented and supported by the health care team.
• Perform telephonic clinical assessments for the identification, evaluation, coordination and management of member's needs, including physical health, behavioral health, social services and long-term services and supports.
• Identify members for high-risk complications and coordinates care in conjunction with the member and the health care team.
• Manage members with chronic illnesses, co-morbidities, and/or disabilities, to insure cost effective and efficient utilization of health benefits.

QUALIFICATIONS

• LVN/LPN in Texas
• 2 + years of experience in a health care role working within a community health setting with direct
• Experience in long-term care, home health, hospice, public health or assisted living.
• Field based case management experience in a managed care setting