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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, focusing on personalized care plans, effective communication with healthcare teams, and compliance with clinical guidelines and regulations.
Highest-signal resume keywords
Registered Nurse - State LicensureResource Utilization Group CertificationCare Plan DevelopmentIn-Person AssessmentsHealthcare Collaboration
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 CoordinationPersonalized Care PlansService Needs EvaluationMember Data ReviewClinical Guidelines Compliance
Soft Skills
CommunicationAdvocacyCollaborationEducationCoaching
Certifications & Qualifications
Registered Nurse - State LicensureResource Utilization Group Certification
Industry Keywords
Continuum of CareHigh-Acuity PopulationsCommunity ResourcesService AuthorizationsQuality of Care
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 the best outcomes
- Identify providers, specialists, and community resources
- Coordinate between members, families/caregivers, and care provider teams
- Monitor care plans, member status, changes in condition, complications, symptoms, and progress toward goals
- Review member data, referrals, and intake assessments to develop and revise care 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 on disease processes, care gaps, provider instructions, care options, referrals, benefits, and community resources
- Act as liaison and member advocate between members/families, physicians, and facilities/agencies
- Coordinate 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
- Partner with leadership to improve quality of care and cost-effective service delivery
- May precept clinical new hires and support onboarding, competency checkpoints, coaching, and readiness
- Perform other duties as assigned
- 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 perform in-person assessments in the Harlingen, Mercedes, Weslaco service delivery area
- Must comply with state and federal regulations, clinical guidelines, policies, and standards
Benefits
Comp & perks- Competitive pay
- 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