Senior RN, LTSS Service Care Manager

Job not on LinkedIn

🔥 21 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 and recommend plans for optimal outcomes • Continuously assess 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, 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 improve quality and develop appropriate care plans • Collaborate with healthcare providers to facilitate services and treatments • Collect, document, and maintain member information and care management activities in compliance with 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 • Coordinate service authorizations for services such as meals, employment, housing, foster care, transportation, and activities of daily living • Perform home and other site visits, potentially once a month or more, to assess member needs and collaborate with resources • Partner with leadership to improve quality and cost-effective service delivery • May precept and coach clinical new hires, support onboarding, and assess competency/readiness • Perform other duties as assigned • Comply with all policies and standards

🎯 Requirements

• Graduate from an Accredited School of Nursing • 4–6 years of related experience • 4–6 years of clinical nursing and/or RN case management or Service Coordination experience within Pediatric Acute Care, Pediatric Home Health, or Pediatric Private Duty Nursing settings • RN qualification • Experience supporting children and adolescents ages 0–18 with complex, high-risk, or high-acuity needs • Ability to work Monday–Friday, 8:00 AM–5:00 PM CST, with flexibility for pediatric members’ school schedules • Travel is required for member assessment visits • Bachelor of Nursing degree preferred • Experience in Home Health, Hospice, Long-Term Care, or Managed Care highly valued

🏖️ Benefits

• Health insurance • 401K plan • Stock purchase plan • Tuition reimbursement • Paid time off plus holidays • Flexible approach to remote, hybrid, field, or office work schedules • Mileage reimbursement for member assessment visits • Additional forms of incentives may be included in total compensation