Nurse Service Coordinator

Service Coordinator-RN/NP/PA

The Service Coordinator-RN/NP/PA (SC-RN/NP/PA) provides STAR Kids Members with initial and ongoing assistance by identifying, selecting, obtaining, coordinating, and using Covered Services and other supports to enhance the Member's well-being, independence, integration in the community, and potential for productivity. The SC-RN/NP/PA provides a holistic evaluation of the Member's individual dynamics, needs, and preferences while providing education and health-related information to the Member, the Member's Legal Authorized Representative (LAR), and the Member's Support Network. Responsible for the coordination of STAR Kids members' covered and uncovered services, including both acute and long-term services and supports (LTSS), while meeting the Member's physical, behavioral, functional, and psychosocial needs. Complies with University Health System's and CFHP's policies, procedures, and protocols for establishing and maintaining good working relationships with co-workers, Health System employees, patients, and guests.

Job Description

• Provide initial and ongoing assistance to STAR Kids Members by coordinating Covered Services and supports.
• Conduct holistic evaluations of Members' individual dynamics, needs, and preferences.
• Educate Members, their Legal Authorized Representatives (LAR), and Support Networks on health-related information.
• Coordinate covered and uncovered services for STAR Kids members, addressing physical, behavioral, functional, and psychosocial needs.
• Maintain compliance with University Health System's and CFHP's policies and procedures.

Requirements

• BSN is preferred.
• At least five (5) recent years of clinical experience, which may include service coordination, case management, quality management, or managed care experience.
• Working knowledge of ICD10, CPT4 coding, InterQual/M&R criteria, Texas Department of Insurance HMO standards, LTSS, and NCQA standards is preferred.
• Supervisory experience is preferred.
• RN must possess current licensure with the Texas State Board of Nurse Examiners.
• Current certification from an appropriate professional agency, such as the Case Management Society, is required or must be obtained within 24 months of accepting the position.