Senior LTSS Service Care Manager, RN

🔥 il y a 5 heures

🤠 Texas – Distant

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💵 $36 - $65 / heure

⏰ Temps Plein

🟠 Senior

👔 Manager

👻 Score fantôme 0%

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🗣️🇺🇸🇬🇧 Anglais requis

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Logo of Centene Corporation

Centene Corporation

10 000+ employés

Fondée en 1984

🛡️ Assurance

💼 Conseil

🏥 Santé

Insurance • Consulting • Healthcare

La société Centene Corporation est un leader dans la fourniture de services de santé subventionnés par le gouvernement, spécialisée dans la délivrance de solutions de santé abordables et de haute qualité. Depuis plus de 40 ans, Centene s’est concentrée sur la transformation de la santé des communautés en élargissant l'accès aux services de Medicaid, Medicare, et au marché de l'assurance santé, tout en servant les communautés militaires à travers le programme TRICARE. En tant que plus grande organisation de gestion des soins Medicaid et un acteur clé du marché, Centene met l'accent sur une prestation de soins de santé localisée combinée à des partenariats solides avec des organisations à but non lucratif pour répondre aux besoins uniques de ses membres. Centene s’engage également pour le développement durable et la responsabilité sociale des entreprises, en privilégiant la gestion environnementale et la gouvernance éthique afin d'améliorer le bien-être des communautés qu’elle dessert.

Description

• 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 of complex or high-risk/high-acuity members and recommend plans for optimal outcomes • Continuously assess long-term care plans and collaborate with care management teams to identify providers, specialists, and community resources • Coordinate between members/families/caregivers and care provider teams to ensure appropriate person-centered care • Monitor care plans, member status, changes in condition, complications, clinical symptoms, and progress toward goals • Revise and update care plans as needed • Assess needs for potential entry into higher levels of care and/or waiver eligibility • Review member data, referrals, and intake assessments to improve quality and develop appropriate care plans • Collaborate with healthcare providers to facilitate services, treatments, and revised care plans • Collect, document, and maintain member information and care management activities in compliance with state, federal, and clinical guidelines • Educate members and families/caregivers on disease processes, care gaps, provider instructions, care options, referrals, and healthcare benefits • Act as liaison and member advocate between members/families, physicians, and facilities/agencies • Coordinate community resources and service authorizations for services such as meals, employment, housing, foster care, transportation, and activities of daily living • May conduct home and/or other site visits to assess member needs and collaborate with resources • 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

🎯 Exigences

• 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 nurse licensure required • For Superior: Resource Utilization Group (RUG) certification must be obtained within 90 days of hire • For Arkansas Total Care plan: driver's license required • For Arkansas Total Care plan: child and adult maltreatment checks before hire and recurring • For Arkansas Total Care plan: drug screen at time of hire and recurring • For Arkansas Total Care plan: must reside in Arkansas or a border city • Travel: 5% required

🏖️ Avantages

• Health insurance • 401K plan • Stock purchase plans • Tuition reimbursement • Paid time off plus holidays • Flexible approach to remote, hybrid, field or office work schedules • Additional forms of incentives may be included in total compensation • Diversity and equal opportunity employer

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