Senior LTSS Service Care Manager; RN

Position: 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

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