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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 .
About the role
Key responsibilities & impact- Assess and coordinate medical and supporting services across the continuum of care for complex/high acuity populations
- Develop personalized care plans/service plans for long-term care members
- Evaluate service needs and recommend plans for optimal outcomes
- Continuously assess care plans and collaborate with care management teams, providers, specialists, and community resources
- Coordinate between members, families/caregivers, and care provider teams to ensure appropriate person-centered care
- Monitor member status, complications, symptoms, progress, and changes in condition
- Review member data, referrals, and intake assessments to develop and revise care plans
- Collect, document, and maintain member information and care management activities
- Educate members and families/caregivers on 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 for services such as meals, employment, housing, foster care, transportation, and activities of daily living
- Perform home and/or other site visits, potentially once a month or more, to assess member 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 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
- Must be licensed in Texas
- Experience assessing and coordinating services for complex/high acuity populations
- Knowledge of long-term care, care plans/service plans, healthcare providers, community resources, and benefits
- Ability to comply with 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
- Equal opportunity employer committed to diversity