Utilization Management Case Manager Rn Jobs (NOW HIRING)

Hiring Department: Dell Medical School

Position Open To: All Applicants

Weekly Scheduled Hours: 40

FLSA Status: Exempt from FLSA

Earliest Start Date: Immediately

Position Duration: Expected to Continue

Location: AUSTIN, TX

PURPOSE

The Case Manager Registered Nurse (RN) is a clinically experienced registered nurse responsible for coordinating comprehensive care for patients with complex and chronic medical conditions. The role promotes continuity of care across care transitions and intraclinic services through comprehensive assessment, advanced clinical judgment, and the development of individualized plans of care. The Case Manager RN engages and supports patients through education to promote informed decision-making, self-care, and improved health outcomes, while enhancing the quality of patient care management and satisfaction. In collaboration with interdisciplinary teams, patients, and families, the role supports care coordination, patient advocacy, and discharge planning to ensure safe, timely, and effective transitions of care. The Case Manager RN contributes to the delivery of high-quality, cost-effective care across the continuum of care.

A hybrid work schedule (working onsite and remotely) is available for this position after onsite training and successful performance review have been completed.

RESPONSIBILITIES

Assessment and Care Planning

• Conducts comprehensive initial and ongoing assessments of patients' medical, psychosocial, functional, and environmental needs.
• Develops, implements, and routinely updates individualized plans of care that address clinical interventions, treatment goals, and self-management strategies.
• Applies advanced clinical judgment and critical thinking to identify appropriate interventions, services, and community resources aligned with patient care goals.

Care Coordination and Resource Navigation

• Serves as a primary liaison among physicians, social workers, therapists, and other healthcare professionals to support effective communication and coordinated care delivery.
• Coordinates discharge planning and transitional care in collaboration with interdisciplinary teams to ensure safe, timely, and effective transitions across care settings.
• Facilitates timely follow-up care and resource coordination to support continuity of care and reduce preventable readmissions.
• Coordinates and facilitates access to community-based resources that address social determinants of health, including housing, food insecurity, transportation, financial barriers, and behavioral health services.

Patient and Family Education and Support

• Provides education to patients and families regarding diagnoses, treatment plans, and available resources.
• Engages patients and families in shared decision‑making and self‑management education to support individualized care planning.
• Advocates for patients' needs and preferences throughout the care continuum.

Documentation and Regulatory Compliance

• Maintains accurate, timely, and comprehensive documentation in the electronic medical record in accordance with departmental, organizational, and regulatory standards.
• Ensures compliance with federal, state, and local regulations and applicable accreditation and regulatory requirements.

Professional Practice, Quality, and Team Collaboration

• Participates in interdisciplinary rounds, care team meetings, case conferences, and organizational initiatives.
• Engages in ongoing professional development to maintain licensure and competency in evidence-based practices.
• Contributes to quality improvement and quality assurance initiatives related to patient outcomes, utilization management, and case management practices.

REQUIRED QUALIFICATIONS:

• Bachelor's Degree in Nursing (BSN) from an accredited program
• At least 3 year(s) of experience in relevant nursing experience in an outpatient, clinical, or hospital setting supporting patients with complex or chronic care needs.
• Demonstrated knowledge of care and case management, along with efficient resource and utilization management.
• Familiarity with Medicare/Medicaid and managed care principles.
• Current, unrestricted Registered Nurse (RN) licensure in the state of Texas.
• Basic Life Support (BLS) certification within 6 months of hire.

PREFERRED QUALIFICATIONS:

• Master's Degree in Nursing (MSN) from an accredited program
• At least 5 year(s) of experience inambulatory or hospital setting in case manage and/or care coordination.
• Bilingual in English and Spanish.
• Certification in Case Management (CCM, ACM-RN, or RN-BC) preferred.

$88,000+ depending on qualifications

WORKING ENVIRONMENT/EQUIPMENT

• Standard office equipment and environment
• Repetitive use of a keyboard
• For healthcare jobs, may be exposed to such occupational hazards as communicable diseases, blood borne pathogens, ionizing and non-ionizing radiation, hazardous medications and disoriented or combative patients, or others.

• Resume/CV
• 3 work references with their contact information; at least one reference should be from a supervisor
• Letter of interest