Senior LTSS Service Care Manager (RN)

Position Title: Senior LTSS Service Care Manager (RN)

Work Location: Texas

Assignment Duration: 6 months (Possibility to extend or convert)

Work Schedule: Monday - Friday (8am-5pm)

Work Arrangement: Remote (field visits 3-4 times/week in that SDA)

Position 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.
• 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.

• Star Plus Waiver Assessment team at our organization.
• The team all works remote. It consists of RN's, Social Workers, and Care Management Support Coordinator II's. It's a mix of FTE & Contingent staff. The RN's perform visits to members homes to complete Waiver Upgrade Assessments.

• Will perform 3-4 in home visits with members/week to complete the Waiver Upgrade Assessment. The remainder of time is used to complete documentation & assist in coordinating services for the member. This can include calling MD offices, clinics, DME companies, & other providers to set up/coordinate member MD appointments, services, supplies and equipment.
• The travel for the member visits averages 1-2 hours one-way. These visit in the member's home typically take 2-3 hours, in addition to travel time.
• This role is fast paced and requires excellent multi-tasking skills and someone who is a fast learner.
• The team primarily interacts with each other & other departments through telephone calls, messages on Microsoft Teams, email, and video.
• Training is remote, except for field visit training, that will be performed with one of the nurses on the team. There may also be some in-person training required at an office.

• Requires Graduate from an Accredited School of 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 must be obtained within 90 days of hire required.
• Must haves: RN License, Reliable transportation, Driver's License, Reliable internet
• Nice to haves: RUG or PDPM Certification, 4-6 years of experience working with the adult Aged, Blind, or Disabled population, Prior experience as a Care Manager or Service Coordinator for a Managed Care Organization, or similar, Previous experience working remotely (training is remote)
• Disqualifiers: not in the correct region being sourced, not ready for field visits, not having done any remote work in the past
• Performance indicators: being able to complete at least 3 visits per week. There is an Audit Score of 90% that will need to be met