Care Manager for Complex Care Populations
2 weeks ago
You could be the one who makes a difference in the lives of our 28 million members. At Superior HealthPlan, we are transforming the health of our communities, one person at a time.
As a Senior LTSS Service Care Manager, you will have access to competitive benefits and a fresh perspective on workplace flexibility.
Location: Position is hybrid. Candidate must reside in/around Webb County, TX.
Responsibilities:
- Evaluate the service needs of complex or high-risk members and develop a personalized care plan to ensure the best possible outcomes.
- Assess ongoing long-term care plans and collaborate with the care management team to identify providers and resources needed to address member needs.
- Coordinate and manage interactions between members, caregivers, and healthcare providers to ensure high-quality, person-centered care.
- Monitor member progress and revise care plans as necessary to meet goals and needs.
- Review member data to identify trends and improve operating performance and quality care.
- Collaborate with healthcare providers to facilitate member services and determine revised care plans if needed.
- Maintain accurate records of member information and care management activities to ensure compliance with state and federal regulations.
- Provide education and support to members and their families/caregivers on disease processes, resolving care gaps, and healthcare options.
- Act as a liaison and advocate between members, physicians, and facilities/agencies.
- C coordinate community resources and provide authorization for various services based on assessment and plans.
Requirements:
- Graduate from an accredited school of nursing or bachelor's degree with 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.
- RUG certification must be obtained within 90 days of hire.
Pay Range: $34.81 - $62.54 per hour
Superior HealthPlan offers a comprehensive benefits package including competitive pay, health insurance, 401K and stock purchase plans, tuition reimbursement, paid time off plus holidays, and flexible work arrangements.
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