Registered Nurse Case Manager - Field in Denton, Flower Mound, Northlake and surrounding areas, TX

Position Summary

Nurse Case Manager (RN) for a work-from-home role that requires frequent local travel for in-home member visits and occasional visits to nursing facilities within the Denton County (Denton, Justin, Ponder, Flower Mound, Highland Village, North Lake).

Key Responsibilities

• Conduct comprehensive telephonic and in-person assessments to evaluate members' medical and behavioral health needs.
• Develop and implement individualized care plans, ensuring alignment with clinical and program guidelines.
• Collaborate in multidisciplinary care reviews to optimize member health results.
• Identify and escalate quality of care concerns through appropriate channels.
• Engage members using motivational interviewing and coaching techniques to encourage healthy lifestyle choices.
• Educate and empower members to actively participate in healthcare decision-making with their providers.
• Use strong negotiation and coordination skills to secure appropriate services and resources.
• Ensure accurate and timely documentation, adhering to regulatory, accreditation, and company standards.
• Serve as a preceptor and mentor to new nurses and clinical staff.
• Foster a positive, supportive learning environment that promotes clinical excellence.

Required Qualifications

• Licensed Registered Nurse in Texas
• 3 or more years of Clinical Nursing Experience
• 1 or more years case management experience
• Must possess reliable transportation and be willing and able to travel up to 75% of the time. Mileage is reimbursed per our company expense reimbursement policy

Preferred Qualifications

• Experience in a Managed Care Organization (MCO)
• STAR Kids program experience
• Bilingual (English/Spanish) preferred

Why Join Us?

• A flexible work-from-home environment with meaningful in-person patient interaction
• Opportunity to make a real impact on member health outcomes and quality of life
• A collaborative team culture focused on growth, mentorship, and clinical excellence