Care Manager Registered Nurse; BOERNE

POSITION SUMMARY/RESPONSIBIILITIES
The Service Coordinator-RN/NP/PA (SC-RN/NP/PA) provides STAR Kids Members with initial and ongoing assistance by identifying, selecting, obtaining, coordinating, and using Covered Services and other supports to enhance the Member's well-being, independence, integration in the community, and potential for productivity. The SC-RN/NP/PA provides a holistic evaluation of the Member's individual dynamics, needs and preferences while providing education and health-related information to the Member, the Member's Legal Authorized Representative (LAR), and the Member's Support Network.

Responsible for the coordination of STAR Kids members' covered and uncovered services, including both acute and long term services and supports (LTSS), while meeting the Member's physical, behavioral, functional, and psychosocial needs. Complies with University Health System's and CFHP's policies, procedures and protocols for establishing and maintaining good working relationships with co-workers, Health System employees, patients and guests.

EDUCATION/EXPERIENCE
BSN is preferred. All candidates must possess at least five (5) recent years of clinical experience, which may include service coordination, case management, quality management or managed care experience. Working knowledge of ICD
10, CPT4 coding, Inter Qual/M&R criteria, Texas Department of Insurance HMO standards, LTSS, and NCQA standards is preferred. Supervisory experience is preferred.

LICENSURE
RN must possess current licensure with the Texas State Board of Nurse Examiners. Current certification from an appropriate professional agency, such as the Case Management Society, is required or is to be obtained within 24 months of accepting the position.