RN Care Manager, Pediatrics
San Antonio, TX
American Traveler
5x8 hrs, Days

Assignment Overview

• Shift: Days, 5x8hrs
• Hours: 40 hrs/wk
• Start Date: Jun 1, 2026
• Length: 13 weeks
• Openings: 1

Description

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.

Details

• Primary Pediatric unit in a children's hospital setting
• Complex pediatric patient population with a caseload of up to 10 or more cases per day
• Inpatient and observation patients requiring comprehensive case management
• Day shift, Monday–Friday, 8:00 AM–5:00 PM (5x8-hour shifts)
• Some weekend and after-hours work may be required as needed
• Familiarity with MIDAS and Meditech EMR systems is preferred

Requirements

• Active RN license in the state of Texas or a valid compact license currently in hand
• Minimum of 5 years of clinical nursing experience in the relevant patient population
• Graduate of an accredited school of nursing required; BSN preferred
• Proficient in word processing and software applications in a Windows environment
• Certification in Case Management preferred
• Experience with Milliman (MCG) guidelines and Interqual criteria highly preferred
• Case management, resource management, and discharge planning experience preferred
• BLS/CPR preferred
• Bilingual (English/Spanish) preferred
• US Social Security Number required for consideration

Additional Information

• Responsible for resource and utilization management, including assessing medical necessity, level of care appropriateness, and applying Milliman/Interqual Care Guidelines
• Leads discharge planning efforts by collaborating with social workers, initiating NaviHealth searches for PAN referrals, and working to meet facility target discharge times
• Monitors and manages length of stay (LOS) against GMLOS using 3M/MIDAS reporting and proactively addresses opportunity days
• Collaborates daily with interdisciplinary care teams including nursing, physicians, and other healthcare professionals during patient care rounds
• Proactively refers cases to physician advisers for peer-to-peer reviews, medical necessity reviews, and denial avoidance
• Documents delays of care, readmissions, and status changes in a timely manner to identify trends and improve interventions
• Reconciles patient benefits and services rendered to minimize financial losses for patients and the facility
• Maintains current knowledge of regulatory compliance requirements (e.g., IMM, Code 44)
• Candidates must reside more than 50 miles from the facility to be eligible for travel rates