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Shift: Days, 5x8hrs
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Hours: 40 hrs/wk
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Start Date: Jun 1, 2026
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Length: 13 weeks
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Openings: 1
American Traveler is seeking an experienced RN - Care Manager for a pediatric case management role in San Antonio, TX, requiring a minimum of 5 years of clinical experience and a TX or compact RN license.
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Primary Pediatric unit in a children's hospital setting
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Complex pediatric patient population with a caseload of up to 10 or more cases per day
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Inpatient and observation patients requiring comprehensive case management
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Day shift, Monday–Friday, 8:00 AM–5:00 PM (5x8-hour shifts)
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Some weekend and after-hours work may be required as needed
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Familiarity with MIDAS and Meditech EMR systems is preferred
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Active RN license in the state of Texas or a valid compact license currently in hand
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Minimum of 5 years of clinical nursing experience in the relevant patient population
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Graduate of an accredited school of nursing required; BSN preferred
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Proficient in word processing and software applications in a Windows environment
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Certification in Case Management preferred
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Experience with Milliman (MCG) guidelines and Interqual criteria highly preferred
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Case management, resource management, and discharge planning experience preferred
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BLS/CPR preferred
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Bilingual (English/Spanish) preferred
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US Social Security Number required for consideration
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Responsible for resource and utilization management, including assessing medical necessity, level of care appropriateness, and applying Milliman/Interqual Care Guidelines
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Leads discharge planning efforts by collaborating with social workers, initiating NaviHealth searches for PAN referrals, and working to meet facility target discharge times
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Monitors and manages length of stay (LOS) against GMLOS using 3M/MIDAS reporting and proactively addresses opportunity days
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Collaborates daily with interdisciplinary care teams including nursing, physicians, and other healthcare professionals during patient care rounds
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Proactively refers cases to physician advisers for peer-to-peer reviews, medical necessity reviews, and denial avoidance
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Documents delays of care, readmissions, and status changes in a timely manner to identify trends and improve interventions
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Reconciles patient benefits and services rendered to minimize financial losses for patients and the facility
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Maintains current knowledge of regulatory compliance requirements (e.g., IMM, Code 44)
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Candidates must reside more than 50 miles from the facility to be eligible for travel rates
