Senior LTSS Service Care Manager, RN

🔥 0 minutes ago

🗽 New York – Remote

🗽 New York – Remote

💵 $36 - $65 / hour

⏰ Full Time

🟠 Senior

👔 Manager

👻 Ghost score 0%

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Centene Corporation

WebsiteLinkedInAll Job Openings

10,000+ employees

Founded 1984

🛡️ Insurance

💼 Consulting

🏥 Healthcare

Insurance • Consulting • Healthcare

Centene Corporation is a leading provider of government-sponsored healthcare services, specializing in delivering affordable and high-quality healthcare solutions. For over 40 years, Centene has focused on transforming the health of communities by expanding access to Medicaid, Medicare, and Health Insurance Marketplace services, as well as serving military communities through the TRICARE program. As the largest Medicaid managed care organization and a key participant in the Marketplace, Centene emphasizes localized healthcare delivery combined with strong partnerships with nonprofit organizations to meet the unique needs of its members. Centene is also committed to corporate sustainability and social responsibility, prioritizing environmental stewardship and ethical governance to enhance the well-being of the communities it serves.

📋 Description

• Perform care management duties to 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 • Conduct UAS Assessments for the MLTC member population with Fidelis • Evaluate complex or high-risk/high-acuity members' service needs and recommend care plans • 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, symptoms, and progress toward goals • Review member data, referrals, and intake assessments to improve care quality and operating performance • 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 among members/families, physicians, facilities, and agencies • Coordinate service authorizations for services such as meals, employment, housing, foster care, transportation, and activities of daily living • May conduct home and other site visits, such as monthly or more often, 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 provide coaching, shadowing, onboarding, and competency support • Engage with People Leaders and cross-functional teams to monitor new-hire readiness • Perform other assigned duties and comply with policies and standards

🎯 Requirements

• 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's Nurse Licensure required • Schuyler/Steuben/Livingston/Alleghany county residency required • NY RN Licensure required for eligibility • Ability to conduct UAS Assessments • Knowledge of long-term care, managed care, service plans, healthcare benefits, community resources, and applicable state and federal regulations

🏖️ Benefits

• 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 • Additional forms of incentives may be included in total compensation • Equal opportunity employer committed to diversity