Top 4 Utilization review nurse Jobs in Angleton, Tx

Case Manager
Nurturing Haven LLc —Rosharon, TX
- $23.55 - $28.36 an hour
- Full-time
- Bilingual
- Background check
- HIPAA
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Case Manager

Nurturing Haven LLc
Rosharon, TX

Quick Apply

Job Details

Full-time
$23.55 - $28.36 an hour

Qualifications

Customer communication
ICD-9
Health information regulatory compliance

Full Job Description

Job Overview

We are seeking a dedicated and compassionate Case Manager to join our dynamic healthcare team. In this vital role, you will coordinate and oversee patient care plans, ensuring seamless communication between patients, families, and healthcare providers. Your expertise will help facilitate discharge planning, manage complex cases, and support patients through their recovery journey. This position offers an exciting opportunity to make a meaningful impact on patient outcomes while working in a fast-paced, collaborative environment. The ideal candidate will bring critical care experience, hospital familiarity, and a passion for delivering exceptional patient service.

Responsibilities

Assess patient needs through comprehensive intake interviews and medical record reviews, ensuring accurate understanding of their health status and social circumstances.
Develop personalized care plans that incorporate medical terminology, discharge planning strategies, and social services to optimize patient recovery.
Coordinate with multidisciplinary teams including social workers, physicians, nurses, and therapists to facilitate appropriate care delivery within hospital settings such as ICU, PICU (Pediatric Intensive Care Unit), or Level I/II trauma centers.
Conduct utilization review and management activities to ensure appropriate resource utilization while adhering to HIPAA regulations and health insurance requirements.
Manage patient documentation using EMR (Electronic Medical Records) or EHR (Electronic Health Records) systems with precision and compliance.
Facilitate communication with patients and their families across diverse cultural backgrounds to provide clear information about treatment options, insurance coverage, and community resources.
Support discharge planning by coordinating social services, home health referrals, and follow-up care to promote smooth transitions from hospital to home or other care facilities.

Qualifications

Proven experience in hospital or acute care settings such as ICU, emergency medicine, or trauma centers; experience in pediatric or behavioral health settings is highly desirable.
Strong knowledge of medical terminology, CPT coding, ICD-9/10 coding systems, and utilization management processes.
Background in nursing or social work with demonstrated expertise in case management practices within managed care environments.
Familiarity with EMR/EHR systems and Microsoft Office applications for documentation and communication purposes.
Excellent client communication skills with the ability to work effectively with individuals from diverse cultural backgrounds.
Knowledge of HIPAA regulations alongside health insurance policies related to discharge planning and patient service.
Bilingual abilities are a plus for serving diverse populations effectively; certification in utilization review or case management is preferred.

Join us in delivering compassionate care that transforms lives! We are committed to fostering an inclusive environment where every team member can thrive while making a real difference in the communities we serve.

Pay: $23.55 - $28.36 per hour

Work Location: In person

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