Senior LTSS Service Care Manager RN
4 weeks ago
You could be the one who changes everything for our 28 million members. Centene 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.
MUST BE LICENSED AND RESIDE IN THE STATE OF TEXAS
Hybrid Position - Field visits and work from home
Service Area: San Angelo, Ballinger, Brady, Bronte, Abilene and surrounding area
Position Purpose:
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. 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
- Reviews member data to identify trends and improve operating performance and quality care in accordance with state and federal regulations
- Reviews referrals information and intake assessments to develop appropriate care plans / service plans
- Collaborates with healthcare providers as appropriate to facilitate member services and/or treatments and determine a revised care plan for member if needed
- 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
- Performs other duties as assigned
- Complies with all policies and standards
Bachelor's degree in Nursing preferred
License/Certification:
- RN - Registered Nurse - State Licensure and/or Compact State Licensure required or
- NP - Nurse Practitioner - Current State's Nurse Licensure required
- For Superior: Resource Utilization Group (RUG) certification required
Centene offers a comprehensive benefits package including: competitive pay, health insurance, 401K and stock purchase plans, tuition reimbursement, paid time off plus holidays, and a flexible approach to work with remote, hybrid, field or office work schedules. Actual pay will be adjusted based on an individual's skills, experience, education, and other job-related factors permitted by law. Total compensation may also include additional forms of incentives.
Centene is an equal opportunity employer that is committed to diversity, and values the ways in which we are different. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, or other characteristic protected by applicable law.
-
Senior LTSS Service Care Manager
2 weeks ago
Lubbock, United States Spectraforce Technologies Full timeTitle: Senior LTSS Service Care Manager (RN)Duration: 06 Months (with possible extension)Location: Remote (Home visits are required Source from Lubbock, Texas) Shift: 8am-5pm Mon - Fri Walk me through the day to day responsibilities of this the role and a description of the project (Outside of Workday JD): Review Emails, Calendar Identify and prioritize...
-
Senior LTSS Service Care Manager
2 weeks ago
Lubbock, United States Spectraforce Technologies Full timeTitle: Senior LTSS Service Care Manager (RN)Duration: 06 Months (with possible extension)Location: Remote (Home visits are required Source from Lubbock, Texas) Shift: 8am-5pm Mon - Fri Walk me through the day to day responsibilities of this the role and a description of the project (Outside of Workday JD): Review Emails, Calendar Identify and prioritize...
-
Senior LTSS Service Care Manager
1 month ago
Lubbock, United States Spectraforce Technologies Full timeTitle: Senior LTSS Service Care Manager (RN) Duration: 06 Months Location: Hutchinson, Potter, Carson, Deaf Smith and Randall 8 am to 5 pm, may require after-hour visits as per member requestDay-to-day responsibilities: Complete in-home assessment which includes: SAI Core A to Core Q ISP EDP Other forms as applicable: 1500 forms, SBP, EVV Assessing the...
-
Senior LTSS Service Care Manager
1 month ago
Lubbock, United States Spectraforce Technologies Full timeTitle: Senior LTSS Service Care Manager (RN) Duration: 06 Months Location: Hutchinson, Potter, Carson, Deaf Smith and Randall 8 am to 5 pm, may require after-hour visits as per member requestDay-to-day responsibilities: Complete in-home assessment which includes: SAI Core A to Core Q ISP EDP Other forms as applicable: 1500 forms, SBP, EVV Assessing the...
-
LTSS Service Care Manager
2 weeks ago
Lubbock, United States Centene Corporation Full timeYou could be the one who changes everything for our 28 million members. Centene 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. Note: Applicants must reside in the state of Texas and be able to...
-
LTSS Service Care Manager
4 weeks ago
Lubbock, United States Centene Corporation Full timeYou could be the one who changes everything for our 28 million members. Centene 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. Note: Applicants must reside in the state of Texas and be able to...
-
LTSS Service Care Manager
2 months ago
Lubbock, United States Centene Corporation Full timeYou could be the one who changes everything for our 28 million members. Centene 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. Note: Applicants must reside in the state of Texas and be able to...
-
LTSS Service Care Manager
4 weeks ago
LUBBOCK, United States Superior HealthPlan Full timeYou could be the one who changes everything for our 28 million members. Centene 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. Position Purpose: Assists in developing, assessing, and coordinating...
-
LTSS Service Care Manager
3 weeks ago
LUBBOCK, United States Superior HealthPlan Full timeYou could be the one who changes everything for our 28 million members. Centene 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. Position Purpose: Assists in developing, assessing, and coordinating...
-
LTSS Service Care Manager
4 weeks ago
LUBBOCK, United States Superior HealthPlan Full timeYou could be the one who changes everything for our 28 million members. Centene 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. Position Purpose: Assists in developing, assessing, and coordinating...
-
LTSS Service Care Manager
1 week ago
Lubbock, United States Centene Corporation Full timeYou could be the one who changes everything for our 28 million members. Centene 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.**Licensed Behavioral Health professionals - LPC, LCSW, or RN with...
-
LTSS Service Care Manager
3 days ago
Lubbock, United States Centene Corporation Full timeYou could be the one who changes everything for our 28 million members. Centene is transforming the health of our communities, one person at a time. As a diversified, national organization, youll have access to competitive benefits including a fresh perspective on workplace flexibility. **Licensed Behavioral Health professionals - LPC, LCSW, or RN with...
-
LTSS Service Care Manager
4 weeks ago
Lubbock, United States Superior HealthPlan Full timeJob DescriptionYou could be the one who changes everything for our 28 million members. Centene 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.Licensed Behavioral Health professionals - LPC, LCSW,...
-
LTSS Service Care Manager
1 week ago
LUBBOCK, United States Superior HealthPlan Full timeYou could be the one who changes everything for our 28 million members. Centene 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. Licensed Behavioral Health professionals - LPC, LCSW, or RN with...
-
LTSS Service Care Manager
4 weeks ago
Lubbock, TX, United States Superior HealthPlan Full timeYou could be the one who changes everything for our 28 million members. Centene 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. Position Purpose: Assists in developing, assessing, and coordinating...
-
Senior Patient Services Specialist
2 months ago
Lubbock, United States Providence Service Full timeDescription Under the direction of the PAS manager, the Senior Patient Access Representative has a clear understanding and knowledge of all functions performed by Patient Access. They are responsible for but not limited to assisting patients during the registration process for scheduled and unscheduled visits. This individual has the knowledge to complete...
-
Senior Patient Services Specialist
4 weeks ago
Lubbock, United States Providence Health & Service Full timeUnder the direction of the PAS manager, the Senior Patient Access Representative has a clear understanding and knowledge of all functions performed by Patient Access. They are responsible for but not limited to assisting patients during the registrat Patient Services, Specialist, Patient Access, Senior, Healthcare, Patient
-
Senior Access Services Specialist
1 week ago
Lubbock, Texas, United States Providence Health & Service Full timeJob OverviewUnder the supervision of the Patient Access Services manager, the Senior Patient Access Representative possesses a comprehensive understanding of all responsibilities associated with Patient Access. This role entails assisting patients throughout the registration process for both scheduled and unscheduled appointments. The individual is equipped...
-
Senior Patient Services Specialist
3 weeks ago
Lubbock, United States Providence Service Full timeDescription Under the direction of the PAS manager, the Senior Patient Access Representative has a clear understanding and knowledge of all functions performed by Patient Access. They are responsible for but not limited to assisting patients during the registration process for scheduled and unscheduled visits. This individual has the knowledge...
-
Senior Patient Services Specialist
4 weeks ago
Lubbock, United States Providence Health & Service Full timeJob DescriptionUnder the direction of the PAS manager, the Senior Patient Access Representative has a clear understanding and knowledge of all functions performed by Patient Access. They are responsible for but not limited to assisting patients during the registration process for scheduled and unscheduled visits. This individual has the knowledge to complete...
