Care Manager RN

4 weeks ago

Lubbock, Texas, United States Superior HealthPlan Full time
Job Description

You could be the one who changes everything for our members. 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

Job 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.

Key Responsibilities:

  • 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

Requirements:

  • Requires Graduate from an Accredited School or Nursing or a Bachelor's degree and 4–6 years of related experience
  • Bachelor's degree in Nursing preferred
  • 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

Benefits:

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.

  • Care Coach Connect RN Case Manager

    3 weeks ago

    Lubbock, Texas, United States UnitedHealth Group Inc Full time

    Care Coach RN Case Manager Job SummaryWe are seeking a skilled Care Coach RN Case Manager to join our team at UnitedHealth Group Inc. As a key member of our care team, you will play a vital role in coordinating care and providing ongoing nursing assessment for patients and their families.Key Responsibilities:Coordinate care and provide initial and ongoing...

  • Senior LTSS Service Care Manager RN

    1 month ago

    Lubbock, Texas, United States Superior HealthPlan Full time

    Job Summary: We are seeking a highly skilled and compassionate Care Manager to join our team. As a Care Manager, you will be responsible for assessing and coordinating the care of complex and high-acuity populations, ensuring they receive the highest quality of care and support.Key Responsibilities:Evaluate the service needs of members and develop...

  • Senior LTSS Service Care Manager RN

    4 weeks ago

    Lubbock, Texas, United States Centene Corporation Full time

    Job SummaryWe are seeking a highly skilled Care Manager to join our team at Centene Corporation. As a Care Manager, you will play a critical role in assessing and coordinating medical and supporting services for complex populations with primary medical/physical health needs.Our ideal candidate will have a strong background in nursing and experience in care...

  • Care Coach Connect RN Case Manager

    4 weeks ago

    Lubbock, Texas, United States UnitedHealth Group Inc Full time

    Care Coach Connect RN Case Manager Job SummaryWe are seeking a skilled RN Case Manager to join our Care Coach Connect team in Texas. As a RN Case Manager, you will be responsible for coordinating care and providing ongoing nursing assessments of patients and their families. You will work closely with interdisciplinary team members and the Care Coach Connect...

  • LTSS Service Care Manager

    4 weeks ago

    Lubbock, Texas, United States Centene Corporation Full time

    Job Summary:Centene Corporation is seeking a highly skilled LTSS Service Care Manager to join our team. As a key member of our care management team, you will be responsible for developing, assessing, and coordinating holistic care management activities for populations with significant mental/behavioral health needs.Key Responsibilities:Develops and...

  • RN Full-Time Position

    1 month ago

    Lubbock, Texas, United States Life Care Full time

    Job Title: RN Full-Time PositionCarillon Senior Living is seeking a compassionate and skilled Registered Nurse to join our team. As a RN Full-Time Position, you will provide direct nursing care to residents and delegate and supervise the care provided by our Quality of Life Specialists/Resident Assistants.Key Responsibilities:Recognize, report, and chart...

  • Care Coach Connect RN Case Manager

    4 weeks ago

    Lubbock, Texas, United States DirectEmployers Full time

    Care Coach Connect RN Case Manager Job DescriptionFor those who want to invent the future of healthcare, here's your opportunity to make a difference. We're going beyond basic care to health programs integrated across the entire continuum of care.The Care Coach Connect RN/Case Manager coordinates care and provides initial ongoing nursing assessment of the...

  • RN Case Manager

    4 weeks ago

    Lubbock, Texas, United States Traditions Health Full time

    Job Summary:Traditions Health is seeking a skilled and compassionate Registered Nurse (RN) to join our team as a Case Manager. In this role, you will be responsible for administering skilled nursing care to clients of all ages in their place of residence, coordinating care with the interdisciplinary team, patients, and their families, and a referring agency....

  • Senior LTSS Service Care Manager

    4 weeks ago

    Lubbock, Texas, United States Superior HealthPlan Full time

    Job DescriptionTransform the lives of our members by delivering high-quality, person-centered care. As a Senior LTSS Service Care Manager at Superior HealthPlan, you will play a critical role in assessing and coordinating medical and supporting services for complex populations.Key Responsibilities:Evaluate the service needs of high-risk members and develop...

  • Pediatric Care Specialist

    4 weeks ago

    Lubbock, Texas, United States Thrive Skilled Pediatric Care Full time

    Job DescriptionThrive Skilled Pediatric Care is seeking a RN/LVN to provide high-quality clinical home care to medically fragile children. The ideal candidate will have a current valid license to practice as issued by the State Board of Nursing and current CPR certification.Responsibilities:Provide skilled pediatric home care to medically fragile...

  • Senior LTSS Service Care Manager

    4 weeks ago

    Lubbock, Texas, United States Centene Corporation Full time

    Job Summary:Centene Corporation is seeking a skilled Care Manager for Long-Term Services and Supports to join our team. As a key member of our care management team, you will play a vital role in assessing and coordinating medical and supporting services for complex/high acuity populations. Your primary goal will be to promote quality, cost-effective care for...

  • RN - PRN Senior Care Professional

    4 weeks ago

    Lubbock, Texas, United States Carillon Senior Living Full time

    Job Title: RN - PRN Senior Care ProfessionalJob Summary:We are seeking a compassionate and skilled RN to provide direct nursing care to our residents in a PRN capacity. As a member of our team, you will have the opportunity to make a meaningful difference in the lives of our residents and their families.Responsibilities:- Provide direct nursing care to...

  • Pediatric Nurse

    4 weeks ago

    Lubbock, Texas, United States Thrive Skilled Pediatric Care LLC Full time

    Job Summary: We are seeking a dedicated and compassionate RN/LPN to join our team at Thrive Skilled Pediatric Care LLC. As a pediatric home health nurse, you will provide high-quality care to our patients in the comfort of their own homes.About Thrive Skilled Pediatric Care: Our company offers a full range of clinical home care services, working...

  • Nurse I

    1 month ago

    Lubbock, Texas, United States Texas Department of Aging & Disability Services Full time

    Job Summary: We are seeking a highly skilled and compassionate Registered Nurse to join our team at the Texas Department of Aging & Disability Services. As a Direct Care RN, you will be responsible for providing high-quality nursing care to individuals with intellectual and developmental disabilities who reside in our state-supported living centers. Key...

  • Care Manager LVN

    4 weeks ago

    Lubbock, Texas, United States MRI Full time

    Job DescriptionAt MRI, we are seeking a skilled Care Manager LVN to join our team. As a Care Manager LVN, you will play a vital role in providing high-quality care to our clients.Key Responsibilities:Assist in telehealth biannual assessments and in-person visits as needed.Complete assigned tasks and document findings in a timely manner.Coordinate with...

  • RN Medical Care Specialist

    4 weeks ago

    Lubbock, Texas, United States vTech Solution, Inc. Full time

    Job Summary: We are seeking a skilled RN Medical Care Specialist to join our team at vTech Solution, Inc. in a float position between units at a Children's Hospital / Level II Pediatric Trauma Center. Key Responsibilities: Float between units as needed, providing medical care to patients Collaborate with healthcare teams to ensure high-quality patient...

  • LTSS Service Care Manager

    4 weeks ago

    Lubbock, Texas, United States Centene Corporation Full time

    Job SummaryWe are seeking a skilled LTSS Service Care Manager to join our team at Centene Corporation. As a key member of our care management team, you will play a critical role in developing and implementing holistic care plans for individuals with complex behavioral health needs.Key ResponsibilitiesDevelop and implement care plans that address the unique...

  • Pediatric Nurse

    4 weeks ago

    Lubbock, Texas, United States Thrive Skilled Pediatric Care Full time

    Job Summary:Thrive Skilled Pediatric Care is seeking a dedicated and compassionate Pediatric Nurse to join our team of skilled professionals. As a Home Health Pediatric Nurse, you will have the opportunity to provide high-quality clinical care to medically fragile children in the comfort of their own homes.About the Role:As a Pediatric Nurse with Thrive...

  • Nurse Case Manager

    4 weeks ago

    Lubbock, Texas, United States AccentCare Full time

    Job Title: Registered Nurse (RN) Case ManagerJob Summary: AccentCare is seeking a Registered Nurse (RN) Case Manager to join our team in Lubbock, Texas. As a RN Case Manager, you will be responsible for providing high-quality patient care and case management services to our patients in their homes.Responsibilities:Provide patient-centered care to patients in...

  • Hospice Care Specialist

    4 weeks ago

    Lubbock, Texas, United States Gentiva Full time

    About the Role:We are seeking a dedicated and compassionate Registered Nurse to join our Hospice team as a Hospice RN. As a Hospice RN, you will provide high-quality patient care and support to patients and their families in their homes, hospitals, and other care settings.Key Responsibilities:Provide direct patient care services to hospice patients and...