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Senior LTSS Service Care Manager, RN
Centene Corporation. Assess and coordinate medical and supporting services across the continuum of care for complex/high-acuity populations .
Core Competencies
Role fitCore Competencies
Use this summary to align your resume positioning with the role.
Demonstrates expertise in care coordination and management for complex populations, with a focus on developing personalized care plans and collaborating with healthcare providers. Proficient in educating members and families on care options and navigating community resources.
Highest-signal resume keywords
Registered Nurse - State LicensureNurse Practitioner - Current State's Nurse LicensureResource Utilization Group CertificationCare CoordinationPatient Advocacy
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 DevelopmentClinical AssessmentData Review and AnalysisMember EducationCommunity Resource Coordination
Soft Skills
CollaborationCommunicationCoachingProblem-Solving
Certifications & Qualifications
Resource Utilization Group Certification
Industry Keywords
Continuum of CareHigh-Acuity PopulationsCompliance StandardsClinical GuidelinesHome Visits
About the role
Key responsibilities & impact- Assess and coordinate medical and supporting services across the continuum of care for complex/high-acuity populations
- Develop and continuously assess personalized long-term care plans/service plans
- Identify providers, specialists, and community resources to address member needs
- Coordinate between members, families/caregivers, and care provider teams
- Monitor member status, care-plan progress, complications, clinical symptoms, and changes in condition
- Review member data, referrals, and intake assessments to improve care quality and operating performance
- Collaborate with healthcare providers to facilitate services and treatments and revise care plans
- Collect, document, and maintain member information and care management activities
- Educate members and families/caregivers on disease processes, care gaps, care options, referrals, and 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 as required, such as monthly or more frequently
- Partner with leadership to improve quality and cost-effective service delivery
- Precept and support clinical new hires, including coaching, shadowing, onboarding, competency checkpoints, and readiness monitoring
- Perform other duties as assigned
Requirements
What you’ll need- Graduate from an Accredited School of Nursing or a Bachelor's degree and 4–6 years of related experience
- Bachelor's degree in Nursing preferred
- RN - Registered Nurse - State Licensure and/or Compact State Licensure required, or NP - Nurse Practitioner - Current State's Nurse Licensure required
- Resource Utilization Group (RUG) certification must be obtained within 90 days of hire
- Must reside in the Harlingen or Mercedes TX area
- Field visits and remote work from home required as part of the hybrid role
- Compliance with applicable policies, standards, and state, federal, and clinical guidelines
Benefits
Comp & perks- Health insurance
- 401K
- Stock purchase plans
- Tuition reimbursement
- Paid time off plus holidays
- Flexible approach to work with remote, hybrid, field or office work schedules
- Additional forms of incentives may be included in total compensation
- Diversity-focused equal opportunity employer