Registered Nurse Case Manager

Nurse III RNCM

Join the Texas Health and Human Services Commission (HHSC) and be part of a team committed to creating a positive impact in the lives of fellow Texans. At HHSC, your contributions matter, and we support you at each stage of your life and work journey. Our comprehensive benefits package includes 100% paid employee health insurance for full-time eligible employees, a defined benefit pension plan, generous time off benefits, numerous opportunities for career advancement and more.

Functional Title: Registered Nurse Case Manager

Job Title: Nurse III RNCM

Agency: Health & Human Services Comm

Department: Four Rivers - Nursing

Posting Number: 19770

Closing Date: 11/03/2026

Posting Audience: Internal and External

Occupational Category: Healthcare Practitioners and Technical

Salary Range: $7,532.75 - $8,886.16

Pay Frequency: Monthly

Salary Group: TEXAS-B-24

Shift: Day

Additional Shift: Days (First)

Telework: Not Eligible for Telework

Travel: Up to 5% Regular/Temporary: Regular

Full Time/Part Time: Full time

FLSA Exempt/Non-Exempt: Exempt

Facility Location: Richmond State Supported Living Center

Job Location City: RICHMOND

Job Location Address: 2100 PRESTON

Other Locations: Richmond

MOS Codes: 290X,46AX,46FX,46NX,46PX,46SX,46YX,66B,66C,66E,66F,66G,66H,66N,66P,66R,66S,66T,66W

Come work in an environment where we truly value and respect those we serve and believe in the mission that all people can achieve a higher level of wellness and independence. The state supported living centers serve people with intellectual and developmental disabilities who are medically fragile or who have behavioral problems. The centers provide campus-based direct services and supports at 13 centers located throughout the state.

If you are looking for a place to work where you can establish a career that is filled with purpose, this is the job for you! Free CEUs and updated resources through Lippincott access for all nurses.

The RN Case Manager performs highly complex professional nursing work for individuals at the SSLC, including individuals with highly specialized medical and behavioral health needs. Provides, evaluates, and coordinates nursing care across assigned caseload. Conducts rounds in homes and infirmary areas to assess health status, review clinical information, identify trends or emerging concerns, and determine compliance with treatment plans, policies, procedures, nursing standards, and quality-of-care expectations. Completes comprehensive assessments, develops and evaluates nursing interventions and care plans, monitors and reviews case management plans and health indicators, and initiates follow-up for changes in condition, abnormal findings, medication or treatment concerns, and other clinical needs. Coordinates care with the IDT, LARs, direct care staff, nursing staff, and health care providers to support continuity of care, treatment decisions, and person-centered services. Supports admissions, transfers, medical appointments, specialized clinics, training, quality assurance reviews, policy and procedure improvement, and specialized nursing activities. Provides leadership, training, coaching, and technical assistance to nursing and direct care staff. Provides hands-on nursing care and performs highly complex and technical nursing tasks as needed. Performs related work as assigned. Works under limited supervision with considerable latitude for initiative and independent judgment.

Starting salary for this position: $ 7,532.75

This position may be eligible to earn additional pay for work performed on evenings, nights and/or weekends.

Essential Job Functions (EJFs): Attends work on a regular basis and may be required to work a specific shift schedule or, at times, even a rotating schedule, extended shift and/or overtime in accordance with agency leave policy and performs other duties as assigned. May serve in an on-call status on a rotating schedule as required to meet operational needs of the facility. Performs highly complex nursing case management for assigned individuals, including those with highly specialized medical and behavioral health needs. Develops, evaluates, and monitors nursing interventions to ensure treatment plans, policies, procedures, nursing standards, and quality-of-care expectations are followed. Conducts rounds in assigned homes and infirmary areas to assess health status, gather information from staff, identify trends or emerging concerns, and determine needed follow-up. Reviews and monitors health indicators, care plans, and clinical records, including vital signs, weight, nutrition, symptoms, medication refusals, injuries, seizures, bowel movements, labs, consults, hospital or infirmary status, IHCPs, acute care plans, DSP instructions, physician orders, MARs, treatment records, incident reports, preventive screenings, immunizations, EKGs, psychotropic medication monitoring, and other recurring health requirements. Uses nursing judgment to identify desired effects, side effects, contraindications, adverse reactions, and clinical trends. Evaluates outcome, communicates concerns to the PCP and IDT and initiates appropriate follow-up. Monitors meal and medication administration at least quarterly and documents observations in the electronic health record. For individuals at medium or high risk for choking or aspiration, conducts meal monitoring at least monthly and documents observations related to condition, signs of illness, pain, coughing, swallowing difficulty, positioning, dining plan use, medication administration technique, and pill texture when applicable. Responds to chronic and acute health care concerns, facilitates treatment and follow-up, communicates with the PCP, LAR, health care team, and IDT, participates in specialized clinics and consultations, provides assessment and feedback related to medical or leisure trips, completes post-hospitalization ISPA and follow-up care, maintains required training, and reports concerns to the CNE/NOO. Performs comprehensive and highly complex physical assessments on a quarterly, annual, and as-needed basis in accordance with training and facility protocols. Completes head-to-toe assessments, nursing reviews, annual assessments, SAMs, fall risk assessments, risk ratings, health care plan recommendations, DSP instructions, and related documentation within required timeframes. Reviews current medical assessments, labs, consults, immunizations, diagnostic testing, meal monitoring records, medication administration observations, suction tooth brushing monitoring, and other required assessments. Conducts appropriate screenings, recognizes signs and symptoms of illness or injury, identifies abnormal findings, determines when referrals or plan changes are needed, develops acute care plans and integrated health care plans, communicates findings to the IDT, and evaluates diagnostic information within the RN scope of practice. Monitors assessment completed by others to ensures care provide is in compliance with policies, procedures, standards of care and quality of service. Actively participates as the nursing expert on the individual's interdisciplinary team (IDT), supporting proactive problem solving related to quality of care, nursing processes, and health-related concerns. Consults with and educates IDT members, the Legally Authorized Representative (LAR), the individual, and other medical care providers about the individual's health care plan and status. Works to achieve consensus, coordinates with providers and staff to support continuity of care, and advocates for the individual's needs and preferences. Analyzes data, evaluates nursing intervention outcomes, and provides input to the IDT to support assessment of the treatment plan. Participates in other required and assigned meetings related to individuals on the caseload, including unit, morning, IDT, ISPA, ISP, psychiatric, CLDP, admissions, critical incident, RCA, transition, committee, daily morning medical, and Incident Management Review Team (IMRT) meetings, or provides information to a designee when assigned. Attends prepared to discuss assessments, documentation, consults, labs, clinic issues, medications, weights, diet, screenings, IHCP goals and interventions, change-of-status needs, tracking and trending information, follow-up needs, risk ratings, care plans, and recommendations. Follows local SSLC policies and protocols to ensure pertinent information, including diagnoses and treatment plans, is clearly communicated to SSLC staff and, when instructed, to guardians or LARs. Coordinates, organizes and leads the nursing team for the individuals on the assigned caseload. Leads and instructs assigning nursing staff on how to best care for the individual. Develops inservice training and health education strategies related to the assigned individuals. Attends daily medical and other meetings to keep abreast of individuals' health status. Actively participates in, and prepares for in advance, essential meetings related to the individuals on the assigned caseload to manage and coordinate health care. During morning meetings, reports relevant information from 24-hour reports, home shift logs, health concerns, clinic logs, hospital or infirmary status, medical appointments, laboratory appointments, restraints, medication or treatment refusals, injuries, falls, missed or cancelled appointments, and significant medical issues. Updates necessary items in the automated