Senior LTSS Service Care Manager (RN)

Position Title: Senior LTSS Service Care Manager (RN)
Location: Remote- TX
Duration: 6 months (possible extension)

Job Summary:

• Provide support to medical, behavioral and social support staff to determine needs, eligibility and services for members.
• Conduct screening and risk assessment interventions per program guidelines. Job Responsibilities: Identify special needs members through the completion of health screens and other resources.
• Work with community outreach/member advocates to coordinate member care.
• Educate providers and community resources on program components and available support services. Educate members with special needs to foster compliance with program and positively impact outcomes.
• Assist with modification and management of care plans, medical consenter or caregiver, and family, if applicable, as well as the managing physician
• Efficiency, quality and compliance with timeliness of required assessments and documentation. Process improvement to improve overall performance concerns; Seeing improvement on UMR cases/audits, improve member outcomes.

• Assist with member tasks - follow up with members regarding coordination of care
• Follow up with providers and doctors' offices

Describe the performance expectations/metrics for this individual and their team:

• Provided a monthly caseload ( up to 20 per month)
• Required to follow up with members on a weekly basis

What makes this role unique:
Allows flexibility as candidate to work remotely. Team members are willing to assist and answer questions for their colleagues when needed.
Candidate Requirements Education/Certification Required: Associate or bachelor's degree in nursing Preferred: 1-2 yrs experience in Case Management Licensure Required: Registered Nurse Preferred: RN (1 year is ideal, but manager is willing to be flexible) Years of experience required:
Must haves: 1-2 yrs experience in Case Management or Home Health, Computer skills, phone skills.
Great to have: MCO experience

Disqualifiers:

Additional qualities to look for: be self-motivated, organized, and able to prioritize tasks. Possess strong documentation skills and must be able to follow policies and work processes.

• Top 3 must-have hard skills stack-ranked by importance

1 Comprehensive clinical assessment skills and critical thinking 2 Detail Oriented - tied to documentation, timeliness and compliance 3 Experience with Case Management and coordination