Clinical - Senior LTSS Service Care Manager (RN)

Pyramid Consulting, Inc; Round Rock (TX); On-site; USD 60,000 - 80,000; Full time

Job summary

An established industry player is seeking a dedicated Clinical - Senior LTSS Service Care Manager (RN) to join their team in the North Austin/Round Rock area. This role offers a unique opportunity to make a significant impact on the lives of individuals with complex health needs. You will be responsible for developing and managing personalized care plans, coordinating with care teams, and ensuring high-quality, cost-effective care. This position not only promises professional growth within a supportive environment but also the chance to work with a leading healthcare organization committed to excellence in service delivery. If you are passionate about making a difference in healthcare, this is the role for you!

Benefits

Health insurance (medical, dental, vision)

401(k) plan

Paid sick leave

Qualifications

• Requires RN licensure and 4-6 years of related experience.
• Bachelor’s degree in nursing preferred for this role.

Responsibilities

• Assess and coordinate care for complex populations to promote quality care.
• Develop personalized care plans and monitor member status for progress.

Skills

Pediatrics

Home Health

Case Management

Education

Bachelor's degree in nursing

Graduate from an Accredited School of Nursing

Job description

Clinical - Senior LTSS Service Care Manager (RN)

Job ID: 25-66904

Pay Range: $40 - $45/hour. Employee benefits include, but are not limited to, health insurance (medical, dental, vision), 401(k) plan, and paid sick leave (depending on work location).

Immediate need for a talented Clinical - Senior LTSS Service Care Manager (RN). This is a 06+ months contract opportunity with long-term potential and is located in North Austin/Round Rock Area TX (Onsite). Please review the job description below and contact me ASAP if you are interested.

Key Responsibilities:

• 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.
• Develops and continuously assesses ongoing long-term care plans/service plans and collaborates with care management team to identify providers, specialists, and/or community resources needed to address member's needs.
• Coordinates and manages as appropriate between the member and/or family/caregivers and the care provider team to ensure members are receiving adequate and appropriate person-centered care or services.
• Monitors care plans/service plans and/or member status, change in condition, and progress towards care plan/service plan goals; collaborate with member, caregivers, and appropriate providers to revise or update care plan/service plan as necessary to meet the member's goals/needs.
• Monitors member status for complications and clinical symptoms or other status changes, including assessment needs for potential entry into a higher level of care and/or waiver eligibility, as applicable.
• Reviews member data to identify trends and improve operating performance and quality care in accordance with state and federal regulations.
• Reviews referrals information and intake assessments to develop appropriate care plans/service plans.

Key Requirements and Technology Experience:

• Key Skills: Pediatrics
• Home Health
• Case Management
• 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.
• For Superior: Resource Utilization Group (RUG) certification required. Evaluates the service needs of the most complex or high risk/high acuity members and recommends a plan for the best outcome.

Our client is a leading Healthcare Industry and we are currently interviewing to fill this and other similar contract positions. If you are interested in this position, please apply online for immediate consideration.

Pyramid Consulting, Inc. provides equal employment opportunities to all employees and applicants for employment and prohibits discrimination and harassment of any type without regard to race, color, religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state or local laws.