RN Care Manager, Pediatrics
San Antonio, TX
PRIDE Health
5x8 hrs, Days
Referral Bonus

Registered Nurse - Care Manager (Travel)

Location: San Antonio, Texas
Contract Length: 13 weeks
Shift: Day shift, 8 AM – 5 PM
Employment Type: Travel, Full Time (5 days/week, 8 hours/day)

Job Summary

• Provide expertise and leadership in resource management for patient care delivery, ensuring compliance with Conditions of Participation (COP).
• Manage inpatient and observation patients through comprehensive assessment, planning, interventions, and evaluation of appropriate level of care.
• Collaborate with healthcare team members to enhance continuity of care, cost effectiveness, and discharge planning.
• Act as a key driver in throughput processes by developing safe discharge plans and monitoring length of stay (LOS) against benchmarks.
• Utilize Milliman/Interqual Care Guidelines and MCG processes for medical necessity, level of care assessments, and documentation.
• Coordinate with social workers and other team members to meet discharge targets and facilitate referrals.
• Participate actively in interdisciplinary patient care rounds daily.
• Use evidence-based tools to analyze trends, improve quality, satisfaction, and reduce cost variation.
• Adapt care methods to meet unique physical, psychological, cultural, and developmental needs of pediatric patients.
• Some weekend and after-hours work may be required.

Patient Population

• Complex pediatric patients, managing up to ten or more cases daily.

Required Qualifications

• Valid RN license in Texas
• Associate of Science in Nursing (ASN) or Associate Degree in Nursing (ADN)
• Minimum of 5 years of pediatric nursing experience, including experience within the last year
• Experience as a Care Manager