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Senior LTSS Service Care Manager, RN
Centene Corporation. Perform care management duties for complex/high acuity populations with primary medical/physical health needs .
Core Competencies
Role fitCore Competencies
Use this summary to align your resume positioning with the role.
Demonstrates expertise in care management for complex populations, including assessment, coordination of services, and development of personalized care plans. Proficient in educating members and families on care options and acting as a liaison among various stakeholders.
Highest-signal resume keywords
RN - Registered Nurse - State LicensureNP - Nurse Practitioner - Current State's Nurse LicensureResource Utilization Group (RUG) CertificationIn-Home Assessment CapabilityCare Management for Complex Populations
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 ManagementAssessment and Coordination of ServicesPersonalized Care PlansMonitoring Clinical SymptomsData Review and Intake Assessments
Soft Skills
Member AdvocacyEducation and CommunicationCollaboration with Stakeholders
Certifications & Qualifications
RN - Registered Nurse - State LicensureNP - Nurse Practitioner - Current State's Nurse LicensureResource Utilization Group (RUG) Certification
Industry Keywords
Complex PopulationsHigh Acuity CareContinuum of CareClinical GuidelinesService Authorizations
About the role
Key responsibilities & impact- Perform care management duties for complex/high acuity populations with primary medical/physical health needs
- Assess and coordinate medical and supporting services across the continuum of care
- Develop and continuously assess personalized long-term care plans/service plans
- Coordinate members, families/caregivers, providers, specialists, and community resources
- Monitor member status, complications, clinical symptoms, care-plan progress, and changes in condition
- Review member data, referrals, and intake assessments to improve quality and develop appropriate care plans
- Facilitate member services, treatments, service authorizations, and community-resource coordination
- 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
- Perform home and/or other site visits as required
- Partner with leadership to improve quality and cost-effective service delivery
- May precept and coach clinical new hires, support onboarding, and assess readiness
- Perform other duties as assigned and comply with all policies and standards
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
- In-home assessment capability and willingness to perform home and/or other site visits
- Compliance with current state, federal, and clinical guidelines
- Ability to assess complex/high acuity populations and coordinate long-term care services
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
- Competitive pay
- Additional forms of incentives may be included in total compensation