RN Care Manager - HEB Wellness Primary Care

Job Description: Job Summary: As a Nurse Care Manager, you’ll work closely with physicians, social workers, and other medical / non-medical professionals to meet patient needs; you’ll promote quality care that includes advocating proper use of available resources and stay engaged so you can recognize the need for current / future care. Identifies patient needs, current services, and available resources; connects services / resources to meet patient needs; develops a patient-focused case management plan.

Job Description:

Job Summary: As a Nurse Care Manager, you’ll work closely with physicians, social workers, and other medical / non-medical professionals to meet patient needs; you’ll promote quality care that includes advocating proper use of available resources and stay engaged so you can recognize the need for current / future care.

Key Responsibilities & Essential Functions:

Patient Care:

• Conduct patient assessments and contribute to individualized, patient-centered care plans
• Help triage and clinically assess our high-risk patients when needed
• Provide care coordination for outpatient and inpatient encounters to support continuity of care
• Support transitional care following hospital discharges, including timely outreach and follow-up scheduling
• Identify gaps in care and opportunities for preventive services
• Educate patients on chronic disease management, medications and self-management techniques
• Coordinate referrals and community resources under established protocols
• Document care management activities accurately in the EHR
• Collaborate with physicians, social workers, referral teams and clinic staff
• Participate in quality improvement and population health initiatives
• Identifies patient needs, current services, and available resources; connects services / resources to meet patient needs; develops a patient-focused case management plan
• Provides case management for all inpatient/outpatient stays/procedures, ensuring continuity of care within the H-E-B Wellness Primary Care clinical systems
• Collaborates with Benefits Care Management partners to ensure continuity of care
• Ensures patients receive medically appropriate services; ensures current / future care

Compliance:

• Explains Patient Care coordination program / process; reviews eligibility / authorization forms on behalf of H-E-B and Partners
• Collaborates with other health care professionals to ensure patients receive appropriate levels of care

Training:

• Educates on the case management process
• Coordinates / provides educational presentations as requested
• Trains support staff on basic care management tasks

The responsibilities and essential functions outlined above describe the general nature and level of work assigned to this position. This is not an exhaustive list of all duties, responsibilities, and skills required. Duties and responsibilities may be modified at any time based on business needs. Employees may be required to perform other job-related tasks as requested by their supervisor, subject to reasonable accommodations.

Qualifications & Key Requirements:

Intermediate individual contributor in a professional role. Works independently within an established framework, receiving detailed instructions only on new assignments. Possesses specialized knowledge and skills required to perform the role. Applies practical knowledge, learned theories, concepts, principles, and methodologies to difficult but non-complex, conventional assignments. Majority of work efforts are focused on meeting objectives related to implementation or delivery of processes, programs, and/or policies.

Builds productive internal and external working relationships.

Work Experience:

• 3+ years of care management or population health experience required
• Experience working with electronic health records

Knowledge/Skills/Abilities:

• Advanced verbal / written communication skills
• Strong interpersonal, negotiation, and conflict-resolution skills
• Strong organization skills
• Bilingual (English – Spanish) skills a plus
• Ability to work independently
• Ability to manage multiple priorities and shift focus between tasks

Education:

• Bachelor’s degree in nursing, public health, etc., or related field

Licenses/Certifications:

• Current, unrestricted State of Texas RN license
• Certified Case/Care Manager (CCM)

Physical Demands & Working Conditions:

• Function in a fast-paced clinic / office environment
• Sit / stand for extended periods
• Work extended hours and / or rotating schedules

The work environment characteristics described here are representative of those a Partner encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

Last revised: 07/10/2026