RN, Senior LTSS Service Care Manager
Core
Assesses and coordinates medical and supporting services for complex/high acuity long-term care members to promote quality, cost-effective care.
Role type
Senior Registered Nurse (RN) Care Manager
Builds
Personalized care plans and service plans for long-term care members
Domain
Healthcare / Long-Term Care / Managed Care
Required skills
Care coordination, care plan development, provider collaboration, member advocacy, clinical assessment, data review for trends, community resource coordination, precepting new hires
Preferred skills
Home health, hospice, or managed care experience, Bachelor of Nursing degree, Resource Utilization Group (RUG) certification
Technologies
Electronic health records (implied via data review and documentation), care management software
Responsibilities
Evaluate service needs of high-risk members and recommend care plans; Develop and continuously assess long-term care plans; Coordinate between members, families, and care providers; Monitor member status and revise care plans as needed; Review member data to identify trends and improve performance; Provide education to members and families on disease processes and benefits; Act as liaison between members, physicians, and facilities; Precept clinical new hires and guide their onboarding; Perform home and site visits to assess member needs.
Seniority
Senior, hands-on IC with mentorship responsibilities