Service Coordinator RN

University Health; San Antonio (TX); On-site; USD 70,000 - 90,000; Full time

Job summary

University Health seeks an RN Service Coordinator to manage LTSS service coordination, supervise staff, and develop care plans that optimize health across the care continuum. The role includes holistic assessments and educating Members, LARs, and Support Networks.

The position requires an active Texas RN license, BSN preferred, and 4+ years of clinical experience in related fields. Knowledge of LTSS, HMO standards, and Medicare/Medicaid experience is valued.

Qualifications

• Graduation from an accredited school of professional nursing or social work is required.
• BSN is preferred.
• Four recent years of clinical experience preferred, including service coordination, case management, quality management, or managed care.
• Working knowledge of HMO standards, LTSS, and NCQA standards is preferred.
• Knowledge of Medicare and Medicaid HMO experience is preferred.
• Experience with vulnerable populations who have chronic or complex conditions is required.
• Bilingual, English/Spanish, is preferred.

Responsibilities

• Coordinate STAR+PLUS Members' covered and non-capitated services, including acute and LTSS.
• Develop, monitor, evaluate, and revise Members’ care plans to meet needs and optimize health care across the continuum.
• Conduct holistic assessments of Members' dynamics, needs, and preferences, and provide education to Members, LARs, and Support Network.
• Provide supervision and direction to staff participating in Members’ cases in accordance with state law and contract.
• Ensure compliance with policies and protocols and maintain good working relationships with coworkers, patients, and guests.

Skills

Staff supervision

Care coordination

Holistic assessment

Education

RN licensure (TX)

BSN preferred

Job description

POSITION SUMMARY/RESPONSIBILITIES

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.