Senior LTSS Service Care Manager (RN)

Position Title : Senior LTSS Service Care Manager (RN)

Work Location : Central SDA Texas - (Austin, Killeen, Temple, Belton, Georgetown, Round Rock, Cedar Park, Waco, Harker Heights, Copperas Cove, San Marcos, Bastrop, Taylor, Marble Falls, Burnet)

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.

Background & Context :

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.

Key Responsibilities :

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.

Qualification & Experience :

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

Education / Certification

Required : Requires Graduate from an Accredited School of Nursing or a Bachelor's degree and 4-6 years of related experience

Preferred : Bachelor's degree in Nursing preferred

Licensure

Required : Registered Nurse, TX

Preferred :

Years of experience required

Disqualifiers

Best vs. average

Performance indicators

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

Best vs. average : RUG Certification, if don't have then will have to get once hired