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Full Time Rn Case Manager Jobs in Edinburg, TX (NOW HIRING)

UHS

Case Manager RN FT

Edinburg, TX

Responsibilities POSITION SUMMARY: RN Case Manager responsible to manage resource utilization and clinical outcomes for patients as well discharge needs of the patients. RN will also be responsible ...

UHS

Case Manager RN FT Edinburg

Edinburg, TX · On-site

Responsibilities POSITION SUMMARY: RN Case Manager responsible to manage resource utilization and clinical outcomes for patients as well discharge needs of the patients. RN will also be responsible ...

Driscoll

Case Manager RN RGV

Edinburg, TX · On-site

The Case Manager is responsible for evaluating, coordinating, and implementing the functions of ... Registered and currently licensed by the Board of Nurse Examiners for the State of Texas. Current ...

Healthcare Support Staffing

LVN Case Manager

Mcallen, TX

$26.25 - $35.25/hr

  • Medical

  • Dental

  • Vision

Are you an experienced LVN looking for a new opportunity with a prestigious healthcare company? Do you want the chance to advance your career by joining a rapidly growing company? If you answered ...

Skilled Nursing Professionals

Case Manager

Mcallen, TX · On-site

$19 - $24.50/hr

Facilitate communication among residents, families, physicians, therapists, nursing staff, and ... For benefit details check us out here Benefits eligibility for some benefits dependent on full time ...

Skilled Nursing Professionals

Case Manager

Mcallen, TX

$19 - $24.50/hr

Facilitate communication among residents, families, physicians, therapists, nursing staff, and ... For benefit details check us out here Benefits eligibility for some benefits dependent on full time ...

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All JobsRn Case JobsFull Time Rn Case Manager JobsFull Time Rn Case Manager Jobs in Edinburg, TX

Full Time Rn Case Manager information

See Edinburg, TX salary details

$13

$34

$57

How much do full time rn case manager jobs pay per hour?

As of Aug 16, 2026, the average hourly pay for full time rn case manager in Edinburg, TX is $34.37, according to ZipRecruiter salary data. Most workers in this role earn between $25.53 and $41.54 per hour, depending on experience, location, and employer.

What is the difference between Full Time Rn Case Manager vs Registered Nurse?

AspectFull Time Rn Case ManagerRegistered Nurse
CredentialsRN license, case management certification often preferredRN license required
Work EnvironmentCase management settings, hospitals, insurance companiesHospitals, clinics, long-term care facilities
Job FocusCoordinating patient care, discharge planning, resource managementDirect patient care, assessments, treatments
Employer & IndustryHealthcare providers, insurance companies, case management firmsHospitals, clinics, healthcare facilities

Full Time Rn Case Managers focus on coordinating patient care and discharge planning, often working in case management settings, while Registered Nurses provide direct patient care across various healthcare environments. Both roles require an RN license, but the case manager role emphasizes care coordination and resource management.

What are the key skills and qualifications needed to thrive as a full time RN case manager, and why are they important?

To thrive as a Full Time RN Case Manager, you need a valid RN license, strong clinical assessment abilities, and experience in care coordination or case management. Familiarity with case management software, electronic health records (EHRs), and knowledge of insurance or utilization review processes are typically required. Excellent communication, problem-solving, and organizational skills help build relationships with patients, families, and interdisciplinary teams. These competencies are crucial for ensuring effective patient care transitions, resource utilization, and improved health outcomes.

How does a full time RN case manager typically collaborate with other healthcare professionals to coordinate patient care?

A Full Time RN Case Manager works closely with physicians, social workers, therapists, and insurance representatives to ensure patients receive comprehensive and coordinated care. This collaboration often involves regular interdisciplinary meetings, care planning sessions, and ongoing communication to update treatment plans and address patient needs. Effective teamwork is essential, as RN Case Managers must advocate for patients while balancing clinical guidelines and resource considerations. Building strong relationships with both internal and external partners is key to successful case management and positive patient outcomes.

Are full time RN case managers in demand?

Full-time RN case managers are in high demand due to the growing need for coordinated patient care, especially in healthcare settings such as hospitals, insurance companies, and community health organizations. The role often requires strong clinical skills, certification, and the ability to manage complex cases, contributing to steady job growth in the healthcare industry.

What does a full time RN case manager do?

A Full Time RN Case Manager is a registered nurse who coordinates and manages patient care, often within hospitals, clinics, or home health settings. Their primary role is to assess patients’ needs, develop care plans, and ensure that patients receive appropriate treatments and services. They act as a liaison between patients, healthcare providers, and insurance companies to facilitate effective and efficient care. RN Case Managers also monitor patient progress and help navigate complex healthcare systems to improve outcomes.

Is being a full time RN case manager worth it?

Full-time RN case managers typically enjoy stable employment, competitive salaries, and opportunities for professional growth. The role involves coordinating patient care, requiring strong communication skills and knowledge of healthcare systems, often with a standard 40-hour workweek. Job satisfaction can depend on work environment, workload, and personal interest in patient advocacy and healthcare management.

What cities near Edinburg, TX are hiring for Full Time Rn Case Manager jobs?

Cities near Edinburg, TX with the most Full Time Rn Case Manager job openings:

Full Time Rn Case Manager jobs near you
Infographic showing various Full Time Rn Case Manager job openings in Edinburg, TX as of August 2026, with employment types broken down into 100% Full Time. Highlights an 100% In-person job distribution, with an average salary of $71,482 per year, or $34.4 per hour.

RN Case Manager-FT- Days- Res Mgmt

DHR Health

Edinburg, TX • On-site

Full-time

Re-posted 8 days ago

DHR Health rating

6.3

Company rating: 6.3 out of 10

Based on 82 frontline employees who took The Breakroom Quiz

670th of 887 rated healthcare providers

Job description

DHR Health - US:TX:Edinburg - Days
Summary:
POSITION SUMMARY:
Under the general supervision of the Case Management Coordinator, the RN Case Manager acts as a patient advocate to hospital clients. An autonomous role that coordinates, negotiates, procures services and resources for, and manages the care of complex patients to facilitate achievement of quality and cost efficient patient outcomes. The RN Case Manager identifies opportunities to reduce cost while ensuring the highest quality of care is maintained. Review criteria are applied to determine medical necessity for admission and continued stay. The RN Case Manager provides clinically based case management, discharge planning, and care coordination to facilitate the delivery of cost-effective quality healthcare and assists in the identification of appropriate utilization of resources across the continuum of care.
The RN Case Manager works collaboratively with interdisciplinary staff internal and external to the organization, and participates in quality improvement and evaluation processes related to the management of patient care. The case manager is on-site and available seven days a week, as well as holidays and, therefore, is required to work a weekend rotation and an occasional holiday and will required to be on call.
POSITION EDUCATION/ QUALIFICATIONS:
  • Graduate from an accredited school for nursing required.
  • A valid license as a Registered Nurse with the State of Texas is required.
  • Certification in Case Management (CCM) is highly desired.
  • Candidate must demonstrate proficiency in both the English and Spanish language.

JOB KNOWLEDGE/EXPERIENCE:
  • Knowledge in the areas of case management and utilization management, experience with Managed Care and utilization management as it relates to third-party payers preferred.
  • Three to five years clinical experience is required, with experience in a Hospital or acute care setting being strongly preferred
  • Experience in use of InterQual and or Milliman criteria and review processes highly desirable.
  • Knowledge and understanding of Medicare and Medicaid guidelines and regulations pertaining to utilization review and discharge planning.

Responsibilities:
POSITION RESPONSIBILITES:
  • Assists in the development and implementation of the case management program.
  • Collaborates with already existing programs and departments to ensure appropriate resource utilization by all patients being followed in a caseload.
  • Works with nurse managers, other clinical departments, and division directors in program development.
  • Establishes and/or attempts appropriate caregiver forums to provide program teaching/information and seeks program effectiveness feedback.
  • Provides orientation and ongoing education specific to case management.
  • Participates in extending case management approach.
  • Acts as a consultant to all disciplines specific to case management program.
  • Performs ongoing evaluation of case management program.
  • Participates in daily rounds, providing education to other team members re: Case Management
  • Provides follow-up to system issues and reports individual practitioner variances appropriately to PA or

Department Director.
  • Participates in respective nursing unit meetings providing Case Management education and new regulatory requirements as needed per the Case Management Supervisor.
  • Directs, coordinates, and provides case management to patients in caseload.
  • Assesses the patients within the caseload to identify needs, issues, resources, and care goals.
  • Through proper reporting mechanisms, completes case management assessment, reviews admitting diagnoses/problem(s), determines plan to address client's needs, and optional/preferred level of care.
  • Develops a discharge plan early on in admission.
  • Implements and coordinates interventions that will lead to goals in plan.
  • Monitors the effectiveness of the plan.
  • Participates in case finding and preadmission evaluation screening to ensure reimbursement.
  • Identifies potential transition planning problems in a timely manner to set up services required.
  • Works with attending physician and care team members to move patient through the hospital system and set up appropriate services or referrals.
  • Identifies need for new resources if gaps exist in service continuum and initiates creative care delivery options
  • Reviews the medical records of all observation and inpatient admissions to determine the medical necessity for admission and continued stay, using pre-established criteria (InterQual or Milliman) with appropriate frequency.
  • Continues review of all patients using criteria and determines need for continued hospitalization based upon third party payer/insurance guidelines.
  • Assesses clinical, including psychosocial, system parameters.
  • Establishes planning to determine goals and objectives and care setting to optimally meet patient needs. Develops a discharge plan in a timely manner.
  • Conducts necessary conferences and team meetings regarding specific patient needs.
  • Implements interventions that lead to the patient accomplishing goals established in plan.
  • Coordinates the necessary resources to accomplish goals developed in plan.
  • Proactively affects system to facilitate efficient flow of care.
  • Gathers information from sources to enable case manager to monitor the plan's effectiveness.
  • Evaluates the effectiveness of the plan (including variance) in reaching patient's outcomes and goals.
  • Makes appropriate changes to plan as necessary.
  • Documents patient/patient representative understanding of case management plan.
  • Documents avoidable day and /or delay in service variances as per policy.
  • Recognizes and immediately intervenes in cases of suspected abuse or neglect.
  • Recognizes National Patient Safety Goals and Core Measures as applicable to the patient populations served.
  • Plays an essential role in assisting physicians, nurses, and staff with an accurate determination of a patient's observation status. The case manager is an important resource in preventing delayed discharges of observation patients.
  • Identifies and monitors observation admissions daily, to determine the correct patient status.
  • Consults with physicians, nursing, admitting, and outside insurance case managers to determine the appropriate status of patient.
  • Assumes the role of review coordinator for observation services; reviews medical record for appropriateness of status and level of care and facilitates the level of care, utilizing InterQual or Milliman for observation.
  • Works with physicians, nurses, staff, patients, and families to arrange prompt and safe discharge.
  • Case managers must take telephone orders from physicians changing patient status from observation to inpatient admission. This should be done when monitoring observation status. A call or page should be made to a physician if the case manager believes that this should be an inpatient admission and should not wait until the 24 hours are ending before conversion. Case managers must actively monitor patients on observation status and seek to clarify their status as close to the 24-hour benchmark as possible.
  • Develops a discharge plan with nursing when appropriate.
  • Completes daily Observation log in a timely manner.
  • Accurately applies InterQual or Milliman criteria 95% of the time in determining status. Refers appropriately to the PA when medical decision making determination is necessary.
  • Consistently follows Condition Code 44 policy when IP status requires changing to Observation for Medicare patients 95% of the time.
  • Consistently follows the Observation policy for all other payers. (correct determination of start time)
  • Reviews the medical records of all inpatient admissions to determine the medical necessity for admission and continued stay, using pre-established criteria.
  • Identifies cases that fail daily to meet criteria and refers these cases to appropriate physician advisor.
  • Assists and educates attending physicians on an on-going basis.
  • Contacts the attending physicians daily on cases that lack adequate documentation warranting acute hospitalization.
  • Contacts the attending physician to notify him or her of the decision to issue notice of non-coverage. Explains UR process and insurance coverage requirements. Obtains physician's written concurrence when necessary.
  • Informs the patient and/or next of kin when insurance coverage must be terminated for the current admission.

Issues HINN letter.
  • Reinstates insurance coverage when the patient's condition becomes acute and meets criteria again. Issues reinstatement letter.
  • Continues review of all patients using criteria and determines need for continued hospitalization based upon third party payer/insurance guidelines.
  • The initial review applying InterQual criteria is completed within 24 hours of admission.
  • Continued Stay Review is completed no greater than every 48 hours (72 hours for Critical Care) or more frequently as dictated by discharge screening criteria.
  • Document timeframe for next review 95% of the time.
  • Proceeds to issue Hospital Issued Notice of Non-coverage and Hospital Requested Review for Medicare patients according to policy.
  • Refers cases not meeting criteria appropriately, following contract requirements for all other payers.
  • Completes case management assessment of patients and support systems in order to facilitate the most appropriate and timely transition plan.
  • Introduces self to the patient/family, explains the case manager role, and provides them with a business card.
  • Assesses documentation in the medical record appropriate to level of care.
  • Documented level of care recorded when needed prior to nursing home placement.
  • Begins to prepare patient/family regarding optional pathway for care including several complications/options that may occur.
  • Provides transitional planning information to patient or patient's representative 24 hours before discharge when appropriate.
  • Documents referrals to nursing homes, rehab, hospitals, and home care.
  • Documents meetings with family, patient, or doctor.
  • Assembles necessary referrals, discharge summary, and pertinent information for placement prior to the day of discharge.
  • Sends forms to institutions or home health agencies within 48 hours of discharge when appropriate.
  • Documents home-care lists and alternate level-of-care facilities lists provided to families when appropriate.
  • Offers choice to Medicare patients and completes documentation as outlined in the policy.
  • Initiates the Important Message to Medicare policy for when discharge has been determined to be within 48 hours or less.
  • Utilizes support staff efficiently. (transportation, FAXing to agencies, chart copying)
  • Communicates the discharge plan to patients/ patient representatives and pertinent healthcare team members.
  • Collaborates with Quality Management Department: Performs quality assessment reviews and studies both concurrently and retrospectively as required by the hospital's PI plan, JCAHO standards, and third-party payer regulations.
  • Applies generic quality screens/indicators concurrently to patient medical records and accurately abstracts relevant patient care data to determine if quality screens are flagged. Performs first line reviews on potential quality issues as requested by director
  • Refers all other potential quality of care issues identified, not reviewed, as part of the quality assessment screening to the physician advisor to facilitate timely follow up.
  • Collects potentially avoidable day data for system Performance Improvement.
  • Refers potentially avoidable day cases to the PA when the medical staff triggers are met.
  • Refers quality issues to the Case Management Supervisor, CMO and/or PA appropriately.
  • Provides clinical data/information to contracted third-party payers while patient is hospitalized to ensure continued reimbursement and to avoid reimbursement delays within 24 hours of request.
  • Accurate InterQual and Milliman documentation that meet the requirements of third party payers for admission certification and continued stay approval is documented 95% of the time.
  • Interacts, communicates, and intervenes with multidisciplinary healthcare team in a purposeful, goal-directed fashion. Works proactively to maximize the effectiveness of resource utilization.
  • Anticipates, initiates, and facilitates problem resolution around issues of resource use and continued hospitalization and discharge planning.
  • Establishes a means of communicating and collaborating with physicians, other team members, the patient's payers, and administrators.
  • Utilizes appropriate resources in cases that present ethical dilemmas.
  • Explores strategies to reduce length of stay and resource consumption within the care-managed patient populations, implements them, and documents the results.
  • Communicates to appropriate members of healthcare team the patients at risk of losing insurance coverage or

HINN notification of Medicare and Medicaid patients.
  • Maintains a proactive role to ensure appropriate documentation concurrently to minimize inefficient resource utilization and prevent loss of reimbursement.
  • Reviews physician documentation and, when needed, follows procedures to seek clarification of documentation relative to diagnosis and comment, on the patient's clinical state
  • Participates in daily rounds on nursing units
  • Refers to PA those cases in which appropriate resource utilization is to be evaluated, such as IP MRI, IP, endoscopy, or whenever the test ordered does not relate to the reason for admission or diagnosis/symptom
  • Other duties as assigned.

Other information:
LINES OF REPSONSIBILITES:
(Chain-of-command)
1. Director of Resource Management
CUSTOMER SERVICE:
Provide excellent customer service to all DHR custome

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About DHR Health

Sourced by ZipRecruiter

DHR Health, located in Edinburg, Texas, is a major player in the healthcare industry, offering a comprehensive range of medical services. Launched in 1997 by Dr. Carlos J. Cardenas and Dr. Manish Singh, the enterprise was established with the emblematic pursuit of raising the healthcare standards of the Rio Grande Valley. Today, it serves as a full-service health system providing advanced specialty care to individuals irrespective of their ability to pay, emphasizing its commitment to the community. In line with its mission statement, DHR Health focuses on the development of a comprehensive health system devoted to ensuring superior health services, education, and financial solvency. With significant contributions to the medical field, like the installation of South Texas's first da Vinci Xi Surgical System, DHR has effectively notched distinct achievements.

Industry

Health care and social assistance

Company size

1,001 - 5,000 Employees

Headquarters location

Edinburg, TX, US

Year founded

1997

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