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Senior RN, LTSS Service Care Manager
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 collaborating with healthcare providers and educating members and families on care options and resources.
Highest-signal resume keywords
RN State LicensureClinical Nursing ExperienceCare ManagementRUG CertificationPediatric Acute Care
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 CoordinationClinical AssessmentPersonalized Care PlansData ReviewMember Advocacy
Soft Skills
CollaborationCommunicationFlexibilityCoaching
Certifications & Qualifications
RUG CertificationRN State Licensure
Industry Keywords
Pediatric Home HealthComplex PopulationsContinuum of CareCommunity ResourcesQuality Improvement
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 and service plans
- Identify providers, specialists, community resources, and services needed to address member needs
- Coordinate members, families/caregivers, and care provider teams to ensure person-centered care
- Monitor member status, complications, clinical symptoms, care-plan progress, and changes in condition
- Review member data, referrals, and intake assessments to improve care quality and develop appropriate plans
- 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, 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
- Conduct home and other site visits, potentially once a month or more, to assess needs and collaborate with resources
- Partner with leadership to improve quality, service delivery, and cost-effectiveness
- May precept and coach clinical new hires, support onboarding, and assess competency readiness
- Perform other duties as assigned 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 experience in Pediatric Acute Care, Pediatric Home Health, or Pediatric Private Duty Nursing
- RN state licensure and/or compact state licensure required, or current state nurse licensure as an NP
- RUG certification must be obtained within 90 days of hire for Superior
- Texas Department of Family & Protective Services (DFPS) background check required
- Travel to conduct member assessments is required
- Flexibility to accommodate pediatric members’ school schedules when needed
- Bachelor of Nursing degree preferred
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
- Mileage reimbursement for member assessment visits
- Total compensation may include additional forms of incentives