Senior LTSS Service Care Manager (RN)

Spectraforce Technologies; Raleigh (NC); Remote; USD 60,000 - 80,000; Full time

Job summary

Spectraforce Technologies, Inc. seeks a Senior LTSS Service Care Manager (RN) for a remote role based in TX, 6-month contract with potential extension. You will support medical, behavioral and social staff, conduct risk assessments, and coordinate member care to improve outcomes.

Strong RN licensure, case management experience, and excellent documentation are required. Flexible schedule offered. Remote work with some collaboration across care teams and providers; you will educate providers and

Qualifications

• Nursing degree required with RN licensure.
• 1–2 years in Case Management or Home Health.
• Strong documentation and computer/phone skills.
• Self-motivated, organized, and able to prioritize tasks.

Responsibilities

• Support medical, behavioral and social support staff to determine needs and services.
• Screening and risk assessment per program guidelines; identify special needs members.
• Coordinate member care with community outreach and advocates.
• Educate providers and community resources on program components and available support services.
• Assist with modification and management of care plans and involvement of family or caregiver and managing physician.
• Ensure timeliness and quality of assessments and documentation; drive process improvements.
• Follow up with members and providers regarding coordination of care.

Skills

Clinical assessment

Detail oriented / Documentation

Case management coordination

Education

Associate or Bachelor's degree in nursing

RN licensure

Tools

Computer skills

Phone skills

Job description

Position Title: Senior LTSS Service Care Manager (RN)

Location: Remote- TX

Duration: 6 months (possible extension)

Job Summary

• Provide support to medical, behavioral and social support staff to determine needs, eligibility and services for members.
• Conduct screening and risk assessment interventions per program guidelines. Job Responsibilities: Identify special needs members through the completion of health screens and other resources.
• Work with community outreach/member advocates to coordinate member care.
• Educate providers and community resources on program components and available support services. Educate members with special needs to foster compliance with program and positively impact outcomes.
• Assist with modification and management of care plans, medical consenter or caregiver, and family, if applicable, as well as the managing physician
• Efficiency, quality and compliance with timeliness of required assessments and documentation. Process improvement to improve overall performance concerns; Seeing improvement on UMR cases/audits, improve member outcomes.

• Assist with member tasks - follow up with members regarding coordination of care
• Follow up with providers and doctors' offices

Describe the performance expectations/metrics for this individual and their team

• Provided a monthly caseload ( up to 20 per month)
• Required to follow up with members on a weekly basis

What makes this role unique

Allows flexibility as candidate to work remotely. Team members are willing to assist and answer questions for their colleagues when needed.

Candidate Requirements

Education/Certification

• Required: Associate or bachelor's degree in nursing
• Preferred: 1-2 yrs experience in Case Management

Licensure

• Required: Registered Nurse
• Preferred: RN (1 year is ideal, but manager is willing to be flexible)

Years of experience required

Must haves: 1-2 yrs experience in Case Management or Home Health, Computer skills, phone skills.

Great to have: MCO experience

Disqualifiers:

Additional qualities to look for: be self-motivated, organized, and able to prioritize tasks. Possess strong documentation skills and must be able to follow policies and work processes.

Top 3 must-have hard skills stack-ranked by importance

• Comprehensive clinical assessment skills and critical thinking
• Detail Oriented - tied to documentation, timeliness and compliance
• Experience with Case Management and coordination