RN, Senior LTSS Service Care Manager
Core
Senior RN Care Manager assessing and coordinating medical and supporting services for complex/high acuity long-term care members to promote quality, cost-effective care.
Role type
Senior IC clinical care manager (long-term services and supports)
Builds
Personalized care plans and service plans for Duals AIP adult members with complex medical needs
Domain
Healthcare / Long-term services and supports (LTSS) / Managed Care
Required skills
Clinical health assessment, care plan development, provider coordination, care monitoring, data trend analysis, referral management, community resource coordination, member/family education, precepting new hires
Preferred skills
Transition of care management, RUG certification, BSN degree, 7+ years clinical case management experience
Technologies
Managed Care Organization (MCO) systems, clinical documentation tools
Responsibilities
Evaluate service needs of high-risk members and recommend outcome plans; Develop and continuously assess long-term care plans; Coordinate between members, families, and care provider teams; Monitor member status for complications and revise care plans; Review member data to identify trends and improve performance; Provide education on disease processes and care options; Act as liaison between members, physicians, and facilities; Precept clinical new hires and guide onboarding; Engage with leadership to enhance quality of care
Seniority
Senior, hands-on IC with mentorship responsibilities