Service Coordinator RN

University Health; San Antonio (TX); On-site; USD 55,000 - 75,000; Full time

Job summary

University Health is seeking an RN Service Coordinator to manage STAR+PLUS member care coordination across LTSS and acute services. You will develop and monitor comprehensive care plans, ensuring outcomes align with member needs and quality standards.

The role requires an RN license in Texas with strong knowledge of managed care, LTSS, and NCQA standards. Bilingual English/Spanish is preferred to support diverse member populations.

Qualifications

• Graduation from an accredited school of professional nursing or social work is required; BSN preferred.
• Four years of clinical experience preferred in service coordination, case management, quality management, or managed care.
• Working knowledge of HMO standards, LTSS, and NCQA standards; Medicare/Medicaid experience preferred.
• Experience serving vulnerable populations is required; bilingual English/Spanish preferred.

Responsibilities

• Coordinate STAR+PLUS Members' covered and non-capitated services including LTSS and acute care.
• Develop, monitor, and revise Members' care plans to meet needs and optimize health outcomes.
• Provide education and information to Members, LARs, and Support Network; supervise staff involved in cases.

Skills

Nursing

Case management

HMO/LTSS knowledge

Bilingual English/Spanish

Education

RN or Social Work degree

BSN preferred

Job description

The RN Service Coordinator-RN (RN-SC) contributes to the Long Term Services and Supports (LTSS) service coordination process by performing activities within the scope of licensure; provides supervision and direction to staff participating in Member’s cases following applicable state law and contract; develops, monitors, evaluates, and revises the Members’ care plans to meet Member’s needs, to optimize health care across the care continuum to enhance the Member's well-being, independence, integration in the community, and potential for productivity. The RN-SC conducts a holistic assessment of the Member's dynamics, needs, and preferences while providing education and health-related information to the Member, the Member’s Legal Authorized Representative (LAR), and the Member’s Support Network. Responsible for the coordination of STAR+PLUS Members' covered and non-capitated services, including acute and LTSS, while meeting the Member's physical, behavioral, functional, and psychosocial needs. Complies with policies, procedures, and protocols for establishing and maintaining good working relationships with co-workers, employees, patients, and guests.

EDUCATION/EXPERIENCE
Graduation from an accredited school of professional nursing or social work is required. BSN is preferred. Four (4) recent years of clinical experience preferred, which may include service coordination, case management, quality management, or managed care experience. Working knowledge of HMO standards, LTSS, and NCQA standards is preferred. Knowledge of Medicare and Medicaid HMO experience is preferred. Experience in meeting the needs of vulnerable populations who have chronic or complex conditions is required. Bilingual, English/Spanish, is preferred.

LICENSURE/ CERTIFICATION
A current, unrestricted license to practice professional nursing issued by the State of Texas is required.