Clinical - Senior LTSS Service Care Manager (RN)

Axelon Services Corporation; Lubbock (TX); Remote; USD 60,000 - 75,000; Full time

Job summary

A leading company is seeking a Remote Care Manager to assess and coordinate care for high-acuity populations. The role involves developing personalized care plans and educating members on available services. The ideal candidate will have a nursing background and strong communication skills, with responsibilities including home visits and collaboration with healthcare providers.

Qualifications

• RN - Registered Nurse license required.
• Resource Utilization Group (RUG) certification required at hire.

Responsibilities

• Assess members’ health status and treatment plans.
• Develop personalized care plans for long-term care members.
• Coordinate between members, families, and healthcare providers.

Skills

Communication

Care Coordination

Assessment

Education

Bachelor's in Nursing

Graduate from accredited nursing school

Job description

Location : This is a Remote / Member facing position where % of the time the contractor will be visiting members in their homes or facilities in the following counties: Hockley, Lubbock, Crosby, Terry, Lynn, Garza, Lamb, Hale, and Floyd.

Traveling may be within a + mile radius. Preferred counties are: Hockley, Lubbock, Crosby, Terry, Lynn, Garza, Lamb, Hale, and Floyd. Visits will be within the Lubbock Service Delivery Area, which includes counties from Hutchinson to Terry, Lynn, and Garza. Visits may include surrounding counties: Potter, Carson, Deaf Smith, and Randall.

Shift : 8 am to 5 pm, may require after-hour visits as per member request.

Duration : Month-to-month CONTRACT ONLY. No FTE conversion available at this time.

Job Description :

Position Purpose :

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. Develops personalized care plans for long-term care members, addresses issues, and educates members and their families/caregivers on available services and benefits to ensure high-quality, cost-effective care.

Day-to-Day Responsibilities and Project Description :

• Assess members’ current health status, resource utilization, treatment plans, and services.
• Follow up on requests for items/services.
• Communicate with healthcare providers.

Performance Expectations / Metrics :

• Complete successful visits per week.
• Submit assessments within hours of visits.
• Submit all documentation within required turnaround times.
• Conduct visits primarily Monday through Friday; some assessments may require after-hours or Saturday visits.
• Travel to members' homes is necessary; travel time will be considered in productivity metrics.

Education / Experience :

Graduate from an accredited nursing school or hold a Bachelor's degree with related experience. Bachelor's in Nursing preferred.

License / Certification :

RN - Registered Nurse license in the state or a compact state; Resource Utilization Group (RUG) certification required at hire.

Job Duties :

• Evaluate high-risk/high-acuity members and recommend optimal outcomes.
• Develop and assess long-term care and service plans, collaborating with the care team.
• Coordinate between members, families, caregivers, and providers to ensure appropriate, person-centered care.
• Monitor and update care plans based on member status and progress.
• Review data to identify trends and improve quality and performance.
• Review referrals and assessments to develop appropriate care plans.
• Collaborate with healthcare providers to facilitate services and revise care plans as needed.
• Maintain all member information and activities in compliance with regulations.
• Educate members and families on disease processes, care gaps, and healthcare options.
• Act as a liaison and advocate for members.
• Coordinate community resources and service authorizations.
• Perform site visits as needed to assess and address member needs.