Senior RN, LTSS Service Care Manager

🔥 10 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

• Perform care management duties for complex/high-acuity populations with primary medical/physical health needs • Assess and coordinate medical and supporting services across the continuum of care • Develop and continuously assess personalized long-term care and service plans • Identify providers, specialists, community resources, and services needed to address member needs • Coordinate members, families/caregivers, and care provider teams to ensure person-centered care • Monitor member status, complications, clinical symptoms, care-plan progress, and changes in condition • Review member data, referrals, and intake assessments to improve care quality and develop appropriate plans • 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 between members/families, physicians, and facilities/agencies • Coordinate service authorizations for services such as meals, employment, housing, foster care, transportation, and activities of daily living • Conduct home and other site visits, potentially once a month or more, to assess needs and collaborate with resources • Partner with leadership to improve quality, service delivery, and cost-effectiveness • May precept and coach clinical new hires, support onboarding, and assess competency readiness • Perform other duties as assigned and comply with policies and standards

🎯 Requirements

• Graduate from an Accredited School of Nursing • 4–6 years of related experience • 4–6 years of clinical nursing experience in Pediatric Acute Care, Pediatric Home Health, or Pediatric Private Duty Nursing • RN state licensure and/or compact state licensure required, or current state nurse licensure as an NP • RUG certification must be obtained within 90 days of hire for Superior • Texas Department of Family & Protective Services (DFPS) background check required • Travel to conduct member assessments is required • Flexibility to accommodate pediatric members’ school schedules when needed • Bachelor of Nursing degree preferred

🏖️ Benefits

• 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 • Mileage reimbursement for member assessment visits • Total compensation may include additional forms of incentives