Senior LTSS Service Care Manager, RN

Job not on LinkedIn

🔥 15 minutes ago

🤠 Texas – Remote

🤠 Texas – 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

• 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

🎯 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 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

🏖️ Benefits

• 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