RN Case Manager - Health Plan

Cook Children's Health Plan provides vital coverage to nearly 120,000 people in low-income families who qualify for government-sponsored programs in our six county service region. Cook Children's Health Plan provides health coverage for CHIP, CHIP Perinatal, STAR (Medicaid) and STAR Kids Members in the Tarrant county service area. The counties we serve includes Tarrant, Johnson, Denton, Parker, Hood and Wise.

Performs case management activities across the continuum of care in order to promote and facilitate quality, cost effective outcomes and minimize fragmentation of health care delivery for the assigned member population. The Health Plan Case Manager identifies and coordinates short and long term needs of catastrophically/chronically ill and/or injured children/adolescents and their families.

This RN Case Management position will work remotely to perform case management activities across the continuum of care in order to promote and facilitate quality, cost-effective outcomes and minimize fragmentation of health care delivery for the assigned member population. The Health Plan Case Manager identifies and coordinates short and long-term needs of catastrophically/chronically ill and/or injured children/adolescents and their families. Members may have behavioral health conditions, pediatric conditions, high-risk pregnancy, targeted chronic conditions, or need transition of care services. The Case Manager acts as a member advocate, facilitates communication and coordinates care with physicians, clinics, hospital facilities, family, caregivers and other healthcare providers and implements creative solutions to meet members healthcare needs without compromising quality outcomes. Expectations also include supporting health risk reduction through behavioral change and patient education. Case Management activities are completed primarily by telephone.