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Senior RN, LTSS Service Care Manager
Centene Corporation. Perform care management duties to assess and coordinate medical and supporting services 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 management, including the development and coordination of personalized care plans for high-acuity populations. Proficient in assessing member needs, monitoring progress, and ensuring compliance with regulations while advocating for members and facilitating communication among stakeholders.
Highest-signal resume keywords
Registered Nurse (RN) LicensureCare CoordinationCase ManagementResource Utilization Group (RUG) CertificationHome Health Experience
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 ManagementPersonalized Care PlansService CoordinationClinical AssessmentData ReviewMember AdvocacyTreatment FacilitationRegulatory ComplianceHome VisitsOnboarding Support
Soft Skills
CommunicationCollaborationEducationCoachingProblem-Solving
Certifications & Qualifications
Registered Nurse (RN) LicensureNurse Practitioner (NP) LicensureResource Utilization Group (RUG) Certification
Industry Keywords
Long-Term CareManaged CareHome HealthHospiceCare GapsClinical SymptomsMember ServicesService AuthorizationsCommunity ResourcesCare Options
About the role
Key responsibilities & impact- Perform care management duties to assess and coordinate medical and supporting services 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
- Coordinate members, families/caregivers, providers, specialists, and community resources
- Monitor care plans, member status, changes in condition, complications, clinical symptoms, and progress toward goals
- Assess potential entry into higher levels of care and/or waiver eligibility
- Review member data, referrals, and intake assessments to develop and improve care plans and operating performance
- Facilitate member services, treatments, service authorizations, and revised care plans
- Collect, document, and maintain member information and care management activities in compliance with regulations and guidelines
- 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
- Conduct 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 and coach clinical new hires, support onboarding, and assess competency/readiness
- Perform other assigned duties and comply with all policies and standards
Requirements
What you’ll need- Graduate from an Accredited School of Nursing
- 4–6 years of related experience
- RN — Registered Nurse — State Licensure and/or Compact State Licensure required, or NP — Nurse Practitioner — Current State's Nurse Licensure required
- For Superior: Resource Utilization Group (RUG) certification must be obtained within 90 days of hire
- 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
- Travel is required for member assessment visits
- Ability to work Monday–Friday, 8:00 AM–5:00 PM CST
Benefits
Comp & perks- Mileage reimbursement for member assessment visits
- 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