Care Management Nurse RN

About Us Community Health Choice, Inc. (Community) is a non‑profit Managed Care Organization (MCO), licensed by the Texas Department of Insurance. Through its network of more than 10,000 providers and 94 hospitals, Community serves over 400,000 members with the following programs: Medicaid State of Texas Access Reform (STAR) program for low‑income children and pregnant women Children's Health Insurance Program (CHIP) for the children of low‑income parents, including CHIP Perinatal benefits for unborn children of pregnant women who do not qualify for Medicaid STAR Health Insurance Marketplace Plans that offer individual health coverage that includes preventive care, emergency services, prescription drugs, and hospitalization available to all, regardless of pre‑existing conditions Community Health Choice (HMO D‑SNP), a Medicare Advantage Dual Special Needs plan for people with both Medicare and Medicaid that combines Medicare Part A and Part B benefits, Medicare Part D prescription drug coverage, and Medicaid benefits with additional health benefits like dental, vision, transportation, and more Improving members' experiences is at the heart of every Community position. We strive every day to ensure that our members have access to high‑quality health care they need and deserve. Community is accredited by URAC for its health plan operations and offers care management programs for asthma, diabetes, and high‑risk pregnancy. Community is financially self‑sufficient and receives no financial support from Harris Health or Harris County taxpayers. Job Summary The Care Manager will manage Community Health Choice members with chronic disease and medically complicated needs through comprehensive evaluation and coordination of Community resources. The Care Manager will participate as a team member in Community Care Management programs, designed to assist members with chronic diseases in self‑management skills, and work collaboratively with utilization review, member services, and the quality improvement department. Minimum Qualifications Education/Specialized Training/Licensure: RN, current Texas License, CCM required or must receive within 18 months of employment Work Experience: Three years of clinical experience Software Operated: Microsoft Office (Word, Excel, Outlook) Special Requirements Communication Skills: Above average verbal (heavy public contact) Writing/Composing: Correspondence and reports Other Skills: Analytical, medical terminology, research, MS Word, MS Excel Advanced Education: Advanced training specialty CCM preferred Work Schedule: Flexible RESPONSIBLE TO: Supervisor/Manager #J-18808-Ljbffr Harris Health