RESPONSIBILITIES

Manages, supervises and assists the Director Clinical Services - Case Management with oversight of Case Management staff in the Population Health Management department to facilitate high-quality, cost-effective care for Community First Health Plans, Inc. (Community First) STAR, CHIP, Medicare, EPO Members. Works with Community First staff at all levels to facilitate Member satisfaction and unit efficiency.

EDUCATION/EXPERIENCE

Graduation from an accredited school of professional nursing or social work is required. Bachelor's or master's degree Nursing or a related field is preferred. Seven years of clinical nursing case management/service coordination experience with two years of management experience is required. Knowledge of Medicare and Medicaid HMO experience is preferred. Experience in meeting the needs of vulnerable populations who have chronic or complex conditions is required.

LICENSURE/CERTIFICATION

A current, unrestricted license to practice professional nursing issued by the State of Texas is required. Case Management certification, or similar, is preferred. Master’s degree may be considered in lieu of certification. Must have a valid Texas driver’s license and reliable transportation.