Senior LTSS Service Care Manager (RN)

Position Title: Senior LTSS Service Care Manager (RN)

Work Location: Eagle Pass TX

Assignment Duration: 6 Months

Work Schedule: 8am/5pm.

Work Arrangement: Member facing 50% remote - 50% member facing

Position Summary:

Performs care management duties to assess and coordinate all aspects of medical and supporting services across the continuum of care for complex/high acuity populations with primary medical/physical health needs to promote quality, cost effective care.

Background & Context:

You could be the one who changes everything for our members. Our organization is transforming the health of our communities, one person at a time. As a diversified, national organization, you'll have access to competitive benefits including a fresh perspective on workplace flexibility.

Key Responsibilities:

• Develops a personalized care plan / service plan for long-term care members, addresses issues, and educates members and their families/caregivers on services and benefit options available to receive appropriate high-quality care.
• Evaluates the service needs of the most complex or high risk/high acuity members and recommends a plan for the best outcome.
• Develops and continuously assesses ongoing long-term care plans / service plans and collaborates with care management team to identify providers, specialists, and/or community resources needed to address member's needs.
• Coordinates and manages as appropriate between the member and/or family/caregivers and the care provider team to ensure members are receiving adequate and appropriate person-centered care or services.
• Monitors care plans / service plans and/or member status, change in condition, and progress towards care plan / service plan goals; collaborate with member, caregivers, and appropriate providers to revise or update care plan / service plan as necessary to meet the member's goals / needs.
• Monitors member status for complications and clinical symptoms or other status changes, including assessment needs for potential entry into a higher level of care and/or waiver eligibility, as applicable.
• Collects, documents, and maintains all member information and care management activities to ensure compliance with current state, federal, and clinical guidelines.
• Provides and/or facilitates education to long-term care members and their families/caregivers on disease processes, resolving care gaps, healthcare provider instructions, care options, referrals, and healthcare benefits.
• Acts as liaison and member advocate between the member/family, physician, and facilities/agencies.
• Educates on and coordinates community resources. Provides coordination of service authorization to members and care managers for various services based on service assessment and plans (e.g., meals, employment, housing, foster care, transportation, activities for daily living).
• May perform home and/or other site visits (e.g., once a month or more), such as to assess member needs and collaborate with resources, as required.
• Partners with leadership team to improve and enhance quality of care and service delivery for long-term care members in a cost-effective manner.
• May precept clinical new hires by fostering and building core skills, coaching and facilitating their growth, and guiding through the onboarding process to upskill readiness.
• May provide guidance and support to clinical new hires/preceptees in navigating within a Managed Care Organization (MCO) and provides coaching and shadowing opportunities to bridge gap between classroom training and field practice.
• May engage and assist New Hire/Preceptee during onboarding journey including responsibility for completing competency check points ensuring readiness for Service Coordination success.
• Engages in a collaborative and ongoing process with People Leaders and cross functional teams to measure and monitor readiness.

Qualification & Experience:

• Requires a Bachelor's degree and 4 - 6 years of related experience.
• Or equivalent experience acquired through accomplishments of applicable knowledge, duties, scope and skill reflective of the level of this position.
• License/Certification: Valid RN license.
  
  
  
  
  
  

  Candidate Requirements
  Education/Certification	Required: Bachelor's degree and 4-6 years of related experience	Preferred: Bachelor's degree in Nursing
  Licensure	Required: RN ASN, BSN, or MSN	Preferred:
  Years of experience required Disqualifiers Best vs. average Performance indicators	Must haves: Microsoft Suites Nice to haves: Ability to take direction Self disciplined sufficient Case Management experience Disqualifiers: les than a year on job, except contract workers Performance indicators:
  Top 3 must-have hard skills Level of experience with each Stack-ranked by importance Candidate Review & Selection	1	2 years or more of nursing
  2	Clinical judgement
  3	Pediatric Experience