Top 164 Clinical case Jobs in Mission, Tx

Case Manager
Grand Terrace Rehabilitation and Health Care —McAllen, TX
- Full-time
- Mid-level
- Communication skills
- Commercial
Clinical Research Assistant - FT - Days - Research Dept
DHR Health —Edinburg, TX
- Weekends as needed
- Spanish
- Patient monitoring
- BLS Certification
Discharge Planner
Mission Regional Medical Center —Mission, TX
- Full-time
- LVN
- Hospital
- Computer literacy
13d
Admission Coordinator
BRISTOL HOSPICE - PATHWAYS LLC —Mission, TX
- $21 - $22 an hour
- Full-time
- 18 years or older
- Mid-level
- Office
- Mileage reimbursement
- Health savings account
Quick Apply
Simulated Participant
Simulation & Immersive Learning Center at Texas A&M Health —McAllen, TX
- $25 - $30 an hour
- Contract
- Hybrid work
- Computer literacy
- High school diploma or GED
- University
Quick Apply
Case Manager RN
Mission Regional Medical Center —Mission, TX
- Day shift
- Nursing
- Hospital
- Computer literacy
- 401(k)
Board Certified Behavior Analyst (BCBA)- Up to 50% Telehealth
Attain ABA Therapy —McAllen, TX
- Up to $110,000 a year
- Part-time
- Hybrid work
- Mid-level
- Clinic
- Children
- Continuing education credits
- Commuter assistance
Quick Apply
6d
RN Resource Management Director
DHR Health —Edinburg, TX
- Full-time
- Acute care
- Background check
- Spanish
- Continuing education credits
- Health insurance
Quick Apply
Dental Treatment Coordinator
Red Square Dental —McAllen, TX
- $13 - $16 an hour
- Full-time
- Spanish
- Dental office
- HIPAA
Quick Apply
Hospice Quality Assurance Specialist
El Sinai Hospice and Palliative Care LLC —Edcouch, TX
- $18 - $22 an hour
- Full-time
- Spanish
- LVN
- RN License
- Health insurance
- Paid time off
Quick Apply
Specialty Nutrition Systems, Long-Term Feeding Account Consultant - Dallas / Fort Worth, TX
Avanos Medical —Texas
- Remote
- Skilled nursing facility
- Microsoft Outlook
- Surgery
- Health insurance
- 401(k) matching
Board Certified Behavior Analyst (BCBA)
BrightPath Behavior —Alamo, TX
- $85,000 - $97,000 a year
- Full-time
- CPR Certification
- Management
- BLS Certification
- Continuing education credits
- Relocation assistance
Quick Apply
Case Manager II, ACT, MHA, Pos. #124, Corpus Christi, TX
Nueces County MHMR Community Center —Texas
- $22.98 an hour
- Full-time
- Nursing
- Clean driving record
- Computer literacy
- Mileage reimbursement
- Loan repayment program
Medical Director (Texas Licensed)
Bumblebee Health —Texas
- Part-time
- Remote
- Medicine
- Management
- Psychiatry
Quick Apply
13h
Case Manager II, GR SC, IDD Services, Pos. #245, Corpus Christi, TX
Nueces County MHMR Community Center —Texas
- $22.20 an hour
- Full-time
- Spanish
- Nursing
- Clean driving record
- Mileage reimbursement
- Loan repayment program
14d
Bilingual Care Coordinator (EAP)
National EAP —Texas
- $65,000 a year
- Full-time
- Bilingual
- Background check
- Spanish
- Health insurance
- Dental insurance
Quick Apply
Telehealth Concussion Specialist Doctor (MD/DO with TX License)
Headquarters Health —Texas
- $120 - $400 an hour
- Overtime
- Remote
- Background check
- Medicine
- BC/BE
- Flexible schedule
Quick Apply
Veterinarian
National Veterinary Associates —McAllen, TX
- $110,000 - $130,000 a year
- Email
- Fair chance
- Entry level
- Continuing education credits
- Paid holidays
Case Manager II, Jail COC, MHA, Pos. #561, Corpus Christi, TX
Nueces County MHMR Community Center —Texas
- $22.20 an hour
- Full-time
- Spanish
- Nursing
- Clean driving record
- Mileage reimbursement
- Loan repayment program
Case Manager II, Coordinated Specialty Care, MHA, Pos. #504, Corpus Christi, TX
Nueces County MHMR Community Center —Texas
- $22.20 an hour
- Full-time
- Clean driving record
- Computer literacy
- Mid-level
- Mileage reimbursement
- Loan repayment program

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clinical case jobs near mission, tx

Case Manager

Grand Terrace Rehabilitation and Health Care -
McAllen, TX

Apply Now

Job Details

Full-time

Qualifications

Collaborate with healthcare professionals
Appeals
Care plan evaluation
Medicare
DME
Medical insurance coverage verification
Team leadership
Overseeing healthcare denial management
Mid-level
Community resource coordination in health services social work
Durable medical equipment (DME) coordination
MDS
Transitional care planning in clinical case management
Healthcare referral management
Case appeal in utilization management
Pre-authorization review for utilization management
Utilization management
Care coordination meetings experience
Clinical program data analysis
Clinical outcome improvement
Resource utilization in healthcare
Patient family and caregiver education
Multidisciplinary team collaboration for treatment planning
Concurrent review in utilization management
Meeting facilitation
Patient care leadership
Patient progress monitoring
Health insurance referral requirements
Clinical team leadership
Case referral

Full Job Description

Admissions and Authorization Management

Review referrals and clinical documentation to determine appropriateness for SNF admission.
Coordinate pre-admission assessments and payer eligibility verification.
Obtain and manage insurance authorizations for Medicare Advantage, Managed Care, Commercial, and other payer sources.
Collaborate with hospital discharge planners, physicians, and referral sources to facilitate and streamline care transition to SNF.
Ensure timely communication with payers regarding clinical updates and authorization requests.

Clinical Reimbursement and Care Coordination

Lead and coordinate resident care planning activities with the interdisciplinary team.
Participate in daily clinical meetings, utilization reviews, and care conferences.
Monitor resident progress toward established goals and discharge plans.
Identify barriers to care and implement interventions to improve outcomes.
Facilitate communication among residents, families, physicians, therapists, nursing staff, and managed care companies.
Section GG and PDPM Leadership
- Serve as the clinical champion and facilitator for initial and discharge Section GG function score meetings.
- Drive interdisciplinary collaboration between nursing, therapy, and MDS to ensure precise, accurate, and compliant functional scoring that reflects true patient care needs.

Utilization and Length of Stay Management

Monitor resident length of stay and utilization of services.
Conduct concurrent reviews to ensure medical necessity and continued skilled coverage.
Submit clinical updates and supporting documentation to managed care companies.
Track authorization expirations and ensure uninterrupted coverage.
Analyze payer trends and identify opportunities to optimize reimbursement and resident outcomes.
Utilization Defense: Utilize objective clinical and functional data to build robust clinical justifications for continued skilled stay, effectively communicating functional deficits to managed care payers during concurrent reviews.
Peer-to-Peer and Appeals Managements: Must have the clinical acumen to assist prepping the Medical Director for peer-to-peer reviews and execute expedited appeals when a managed care organization issues an inappropriate discharge.

Discharge Planning and Care Transitions

Coordinate with IDT on individualized discharge plans upon admission.
Coordinate safe and effective transitions to home, assisted living, long-term care, or other settings.
Arrange community resources, durable medical equipment, home health services, and follow-up appointments.
Educate residents and families regarding discharge expectations and available resources.
Monitor readmission risks and implement strategies to reduce avoidable hospitalizations.

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Refine Your Search

clinical case jobs in mission, tx

Case Manager

Clinical Research Assistant - FT - Days - Research Dept

Discharge Planner

Admission Coordinator

Simulated Participant

Case Manager RN

Board Certified Behavior Analyst (BCBA)- Up to 50% Telehealth

RN Resource Management Director

Dental Treatment Coordinator

Hospice Quality Assurance Specialist

Specialty Nutrition Systems, Long-Term Feeding Account Consultant - Dallas / Fort Worth, TX

Board Certified Behavior Analyst (BCBA)

Case Manager II, ACT, MHA, Pos. #124, Corpus Christi, TX

Medical Director (Texas Licensed)

Case Manager II, GR SC, IDD Services, Pos. #245, Corpus Christi, TX

Bilingual Care Coordinator (EAP)

Telehealth Concussion Specialist Doctor (MD/DO with TX License)

Veterinarian

Case Manager II, Jail COC, MHA, Pos. #561, Corpus Christi, TX

Case Manager II, Coordinated Specialty Care, MHA, Pos. #504, Corpus Christi, TX

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