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Senior LTSS Service Care Manager
Centene Corporation. Evaluate service needs of complex or high-risk/high-acuity members and recommend care plans .
Core Competencies
Role fitCore Competencies
Use this summary to align your resume positioning with the role.
Demonstrates expertise in care coordination and case management for pediatric patients, with a strong focus on developing and monitoring care plans, collaborating with healthcare providers, and advocating for member needs. Proficient in navigating complex healthcare systems and ensuring compliance with clinical guidelines and regulations.
Highest-signal resume keywords
RN QualificationClinical Nursing ExperienceCase Management ExperienceCare CoordinationPediatric Care Expertise
ATS Keywords
Tailor your resumeApplicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard Skills
Care Plan DevelopmentMember AssessmentData Review and DocumentationService CoordinationMonitoring Patient ProgressCollaboration with Healthcare ProvidersEducation on Disease ProcessesCommunity Resource CoordinationRegulatory ComplianceClinical Guidelines Adherence
Soft Skills
AdvocacyCommunicationFlexibilityTeam CollaborationCoaching and Mentoring
Certifications & Qualifications
Bachelor of Nursing DegreeAccredited School of Nursing Graduate
Industry Keywords
Pediatric Acute CarePediatric Home HealthPediatric Private Duty NursingHigh-Risk Patient CareCare Management
About the role
Key responsibilities & impact- Evaluate service needs of complex or high-risk/high-acuity members and recommend care plans
- Develop and continuously assess long-term care plans and service plans
- Collaborate with care management teams to identify providers, specialists, and community resources
- Coordinate between members, families/caregivers, and care provider teams
- Monitor care plans, member status, changes in condition, complications, and progress toward goals
- Review member data, referrals, and intake assessments to improve care quality and develop appropriate plans
- Collaborate with healthcare providers to facilitate services and treatments
- Collect, document, and maintain member information and care management activities
- Educate members and families/caregivers about disease processes, care gaps, provider instructions, care options, referrals, and healthcare benefits
- Act as liaison and member advocate between members/families, physicians, and facilities/agencies
- Coordinate community resources and service authorizations, including meals, employment, housing, foster care, transportation, and activities of daily living
- Perform home and other site visits, potentially monthly or more frequently, to assess needs and collaborate with resources
- Partner with leadership to improve quality of care and cost-effective service delivery
- May precept clinical new hires and provide coaching, shadowing, onboarding, and competency support
- Engage with People Leaders and cross-functional teams to monitor new-hire readiness
- Perform other assigned duties and comply with policies and standards
Requirements
What you’ll need- Graduate from an Accredited School of Nursing
- 4–6 years of related experience
- 4–6 years of clinical nursing and/or RN case management or Service Coordination experience within Pediatric Acute Care, Pediatric Home Health, or Pediatric Private Duty Nursing settings
- RN qualification required by the role
- Passion for care coordination and case management
- Experience supporting children and adolescents ages 0–18 with complex, high-risk, or high-acuity needs
- Flexibility to accommodate pediatric members' school schedules when needed
- Travel for member assessments is required
- Ability to comply with state and federal regulations and clinical guidelines
- Bachelor of Nursing degree preferred
Benefits
Comp & perks- Mileage reimbursement for member assessment visits
- Competitive pay
- Health insurance
- 401K plan
- Stock purchase plans
- Tuition reimbursement
- Paid time off
- Paid holidays
- Flexible approach to remote, hybrid, field or office work schedules
- Potential additional incentives as part of total compensation