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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 clinical assessment for high-acuity populations, with a focus on developing personalized care plans and collaborating with multidisciplinary teams. Proficient in clinical documentation and compliance, ensuring quality service delivery and member advocacy.
Highest-signal resume keywords
Registered Nurse (RN) LicensureClinical DocumentationCare CoordinationCase ManagementResource Utilization Group (RUG) Certification
ATS Keywords
Tailor your resumeApplicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard Skills
Clinical AssessmentCare Plan DevelopmentMember AdvocacyData ReviewIntake Assessment
Soft Skills
Problem-SolvingCommunicationAttention to DetailOrganizationTime Management
Certifications & Qualifications
Registered Nurse (RN) LicensureResource Utilization Group (RUG) Certification
Industry Keywords
High-Acuity PopulationsLong-Term CareAssisted LivingHome HealthHospice
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 high-risk/high-acuity members
- Continuously assess care plans and collaborate with care management teams, providers, specialists, and community resources
- Coordinate care among members, families/caregivers, and provider teams
- Monitor member status, clinical symptoms, complications, and progress toward care-plan goals
- Review member data, referrals, and intake assessments to improve care quality and operating performance
- Collect, document, and maintain member information and care-management activities in compliance with guidelines
- Educate members and families/caregivers on disease processes, care options, referrals, benefits, and healthcare instructions
- Act as liaison and member advocate between members/families, physicians, and facilities/agencies
- Coordinate community resources and service authorizations
- Conduct home and other site visits as required
- 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 clinical nursing experience
- RN - Registered Nurse - State Licensure and/or Compact State Licensure required, or NP - Nurse Practitioner - Current State's Nurse Licensure
- Resource Utilization Group (RUG) certification must be obtained within 90 days of hire for Superior
- Strong clinical documentation, problem-solving, communication, attention to detail, organization/time management skills
- Ability to work under quick TAT times and deadlines
- Ability to adapt to changing business needs with openness, flexibility, and professionalism
- Bachelor's degree in nursing (BSN) is preferred
- Preferred: 7+ years of clinical RN Case Management or Care Coordination with adult members in Assisted Living, Home Health, Hospice, Long-Term Care, or Skilled Nursing facilities
Benefits
Comp & perks- Competitive pay
- Health insurance
- 401K plan
- 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 visits