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Medical Management Specialist - RN / Registered Nurse (8274)

Case Manager | Austin, TX | Contract

Job Description
Medical Management Specialist – RN / Registered Nurse
Work Location: Austin, TX

InGenesis is currently seeking a Medical Management Specialist to perform medical management of pediatric member cases with complex, chronic care and special needs. In this role, you will handle the evaluation of care plans designed to optimize the health care of the member.

If you meet the qualifications outlined below, apply today and we’ll reach out to answer any questions you may have!

Job Duties/Responsibilities
• Perform needs assessments, service plan development, and service authorization activities.
• Implement and monitor the individualized service plans (ISP).
• Perform assessments and other care review in the member/family home.
• Work with interdisciplinary team to achieve specific member goals.
• Present information clearly, concisely, and in a positive manner to internal/external customers.
• Retrieve and maintain data in clinical databases.
• Perform other duties as assigned.

Minimum Qualifications
• Current Registered Nurse / RN license in the state of Texas
• 3+ years of experience in direct clinical care to consumers.
• Knowledge of clinical utilization/case management and standardized criteria set.
• Verbal/written communication skills, including discussing medical needs with members.
• Problem solving skills.
• PC proficiency.
• Current driver’s license, reliable transportation, and applicable state insurance.
• Ability and willingness to travel within assigned territory.

Preferred Qualifications
• Knowledge of state and federal regulations related to Medicaid programs.
• Experience with pediatric special needs population.
• Experience with Texas Medicaid programs
• Bilingual in English and Spanish.