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Senior RN LTSS Service Care Manager
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 case management for complex populations, ensuring optimal outcomes through personalized care plans and collaboration with multidisciplinary teams. Proficient in regulatory compliance and member education regarding care options and disease processes.
Highest-signal resume keywords
RN State LicensureCare CoordinationCase ManagementResource Utilization Group CertificationMember Assessment
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 ReviewService AuthorizationCare Quality Improvement
Soft Skills
CollaborationAdvocacyCommunicationCoachingEducation
Certifications & Qualifications
RN State LicensureResource Utilization Group Certification
Industry Keywords
Home HealthHospiceLong-Term CareManaged CareContinuum 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 long-term care and service plans
- 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 members, families/caregivers, and care provider teams to ensure appropriate person-centered care
- Monitor member status, complications, clinical symptoms, changes in condition, and progress toward goals
- Review member data, referrals, and intake assessments to improve care quality and develop appropriate plans
- Facilitate member services, treatments, service authorizations, and community resources
- Collect, document, and maintain member information and care management activities in compliance with regulations and guidelines
- Educate members and families/caregivers about disease processes, care gaps, provider instructions, care options, referrals, and benefits
- Act as liaison and advocate between members/families, physicians, facilities, and agencies
- Conduct home and other site visits, including member assessments
- Partner with leadership to improve quality and cost-effective service delivery
- May precept and coach clinical new hires during onboarding
- 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
- RN state licensure and/or compact state licensure, or current state nurse licensure for Nurse Practitioners, required
- Resource Utilization Group (RUG) certification must be obtained within 90 days of hire for Superior
- Travel to conduct member assessments is required
- Experience in RN care coordination or case management with adult members (21 or older) in Home Health, Hospice, Long-Term Care, or Managed Care is preferred
- Bachelor of Nursing degree is 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 travel when conducting member assessment visits