Senior RN, LTSS Service Care Manager

This is a fully remote position, open to applicants in Texas.

📋 Description

• Evaluate and coordinate medical and supportive services throughout the care continuum for complex/high-acuity populations.

• Create individualized care plans/service plans tailored for long-term care members.

• Assess service requirements and suggest plans for achieving optimal outcomes.

• Regularly review care plans and work with care management teams to identify providers, specialists, and community resources.

• Facilitate communication among members, families, caregivers, and care provider teams to ensure appropriate person-centered care.

• Oversee care plans, member conditions, complications, clinical symptoms, and progress towards established goals.

• Evaluate potential transitions to higher levels of care and/or waiver eligibility.

• Analyze member data, referrals, and intake assessments to enhance quality and formulate suitable care plans.

• Collaborate with healthcare providers to streamline services and treatments.

• Gather, document, and maintain member information and care management activities in accordance with established guidelines.

• Provide education to members and their families/caregivers regarding disease processes, care gaps, provider instructions, care options, referrals, benefits, and community resources.

• Serve as a liaison and advocate for members between families, physicians, and facilities/agencies.

• Manage service authorizations for various services such as meals, employment, housing, foster care, transportation, and daily living activities.

• Conduct home and other site visits, potentially once a month or more, to assess member needs and collaborate with available resources.

• Collaborate with leadership to enhance quality and cost-effective service delivery.

• May mentor and train new clinical hires, assist with onboarding, and evaluate competency/readiness.

• Perform additional duties as required.

• Adhere to all policies and standards.

⛳️ Requirements

• Graduate from an accredited School of Nursing.

• 4–6 years of relevant experience.

• 4–6 years of clinical nursing and/or RN case management or Service Coordination experience in Pediatric Acute Care, Pediatric Home Health, or Pediatric Private Duty Nursing settings.

• RN qualification.

• Experience in supporting children and adolescents aged 0–18 with complex, high-risk, or high-acuity needs.

• Availability to work Monday–Friday, 8:00 AM–5:00 PM CST, with flexibility for pediatric members’ school schedules.

• Travel is necessary for member assessment visits.

• Bachelor of Nursing degree preferred.

• Experience in Home Health, Hospice, Long-Term Care, or Managed Care is highly regarded.

🏝️ Benefits

• Health insurance.

• 401K plan.

• Stock purchase plan.

• Tuition reimbursement.

• Paid time off plus holidays.

• Flexible options for remote, hybrid, field, or office work schedules.

• Mileage reimbursement for member assessment visits.

• Additional forms of incentives may be included in total compensation.