Bilingual Nurse Case Manager Medix - 3.7 Cockrell Hill, TX Job Details Full-time $87,000 - $97,000 a year 10 hours ago Qualifications Medicare Electronic health records (EHR) management RN License Managed care organization experience Health insurance knowledge Productivity software Healthcare reimbursement methods Managing patient records Technical Proficiency Cross-functional communication

Full Job Description Job Title:

Bilingual Nurse Case Manager Location:

Dallas, TX 75208

Work Schedule:

Hybrid, Monday-Friday, 8:00 AM - 5:00 PM (2-3 days onsite per week)

Employment Type:

Full-Time, Direct Hire Position Overview We are seeking a dedicated Bilingual Nurse Case Manager to join our multidisciplinary outpatient care team. In this role, you will work directly with high-risk patient populations, helping to manage chronic conditions, oversee smooth transitions of care, and navigate social determinants of health. You will serve as a core advocate and strategist for complex cases, collaborating closely with primary care providers, external facilities, health plans, and community resources to ensure coordinated, high-quality care. Key Responsibilities Complex Case & Chronic Care Management Oversee chronic care management and clinical care pathways for high-risk, complex patient populations within an outpatient setting. Conduct comprehensive physical, mental, and social risk assessments to identify barriers to care and address social determinants of health (SDOH). Develop, implement, and adjust individualized care plans in collaboration with physicians, nursing staff, clinical pharmacists, and social workers. Perform clinical triage via phone, providing immediate guidance or routing issues to appropriate care team members. Transitions of Care & Readmission Prevention Facilitate seamless patient transitions from acute and post-acute settings (hospitals, SNFs) back to the home or transitional facilities. Apply evidence-based care transition models (such as the Coleman Model) to support patient recovery and reduce unnecessary re-hospitalizations. Review and reconcile post-discharge medications alongside primary care providers and clinical pharmacists. Coordinate essential post-discharge resources, including Home Health, Durable Medical Equipment (DME), hospice, and specialist referrals. Ensure primary care or specialist follow-up appointments are scheduled within 7 days of discharge. Obtain and review acute care records, diagnostic results, and discharge summaries to maintain continuity of care. Interdisciplinary Collaboration & Quality Improvement Partner with payers, external case managers, and community organizations to streamline resource allocation and eliminate care delivery barriers. Track readmission data and participate in clinical performance improvement initiatives aimed at optimizing patient outcomes, fiscal efficiency, and patient satisfaction. Document all assessments, phone interactions, and care plans accurately in the Electronic Medical Record (EMR) in a timely manner. Utilize conflict resolution and advanced communication skills to navigate complex care scenarios and provider alignment.

Qualifications & Requirements Education & Licensure License:

Active Registered Nurse (RN) License in Texas or an active Compact/Multi-State RN License (Required).

Education:

Bachelor's Degree in Nursing (BSN), Healthcare Administration, or a related field (Preferred).

Experience & Skills Language:

Bilingual in English and Spanish (Strongly Preferred).

Experience:

Minimum 2 years of clinical RN experience.

Specialty Experience:

Minimum 2 years in case management, chronic care management, utilization management, discharge planning, transitions of care, or value-based care programs.

Knowledge Base:

Working knowledge of managed care reimbursement, Medicare Advantage, value-based care models, and post-acute community resources.

Technical Skills:

Proficiency with Electronic Medical Record (EMR) systems and Microsoft Office Suite; comfortable using data to track care goals.

Soft Skills:

Strong clinical judgment, time management, negotiation, and cross-functional communication skills.

For California Applicants:

We will consider for employment all qualified Applicants, including those with criminal histories, in a manner consistent with the requirements of applicable federal, state and local laws, including the City of Los Angeles' Fair Chance Initiative for Hiring Ordinance (FCIHO), Los Angeles Fair Chance Ordinance for Employers (ULAC), The San Francisco Fair Chance Ordinance (FCO) , and the California Fair Chance Act (CFCA). This position is subject to a background check based on its job duties, which may include patient care, working with vulnerable populations, access to financial and confidential information, driving, working with heavy machinery, or working in a warehouse or laboratory environment. Due to these job duties, this position has a significant impact on the business operations and reputation, as well as the safety and well-being of individuals who may be cared for as part of the job position or who may interact with staff or clients.