Clinical - Senior LTSS Service Care Manager (RN)

Axelon Services Corporation; Texas; On-site; USD 60,000 - 90,000; Full time

Job summary

An established industry player is seeking a dedicated RN Care Manager to join their team. In this role, you will assess and coordinate care for members with complex health needs, ensuring high-quality, cost-effective services. You will develop personalized care plans, conduct home visits, and educate members and their families about available resources. This position offers an opportunity to make a significant impact in the lives of individuals while working within a supportive environment. If you are passionate about patient care and have a knack for coordination, this role is perfect for you.

Qualifications

• RN license required; pediatrics experience is a plus.
• Resource Utilization Group (RUG) certification required.

Responsibilities

• Perform care management duties for complex/high acuity populations.
• Develop personalized care/service plans for long-term care members.
• Educate members and families on available services and benefits.

Skills

Care Coordination

Assessment Skills

Documentation

Patient Education

Proficiency in Outlook

Proficiency in Excel

Proficiency in Word

Proficiency in Microsoft Teams

Education

RN - Registered Nurse

NP - Nurse Practitioner

Resource Utilization Group (RUG) certification

Job description

Work Location:

Texas Hidalgo SDA, sourcing from Harlingen / Brownsville and surrounding areas. RN Care Manager will travel to member homes 3 days a week to complete assessments. Distance varies depending on member location.

Shift:

Monday - Friday, 8 am - 5 pm

Duration:

6 months contract only

Job Duties:

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

• Completing assessments
• Completing biannual reviews
• Care coordination
• Follow-up on requests from members / LAR
• Completing all assigned trainings
• Completing all required documentation
• Submitting authorizations
• Travel for home visits to complete assessments
• Maintaining at least 92% audit score
• Providing member / LAR education
• Preparing productivity reports
• Following up on HEDIS measures
• Assisting members / LARs with finding doctors, therapy agencies, PCS agencies, DME, etc.

Must Haves:

RN license required; pediatrics experience is a plus. Proficiency in Outlook, Excel, Word, and Microsoft Teams.

Nice to Have:

Pediatrics experience.

Education / Experience:

RN - Registered Nurse with state licensure and/or compact licensure required, or NP - Nurse Practitioner with current state licensure. Resource Utilization Group (RUG) certification required at time of hire.