Senior RN, LTSS Service Care Manager

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

📋 Description

• Execute care management responsibilities for complex and high-acuity populations with primary medical and physical health needs.

• Evaluate and coordinate medical services and additional support across the entire continuum of care.

• Create and continually assess customized long-term care and service plans.

• Identify the necessary providers, specialists, community resources, and services to meet member needs.

• Coordinate with members, families/caregivers, and care provider teams to ensure a person-centered approach to care.

• Monitor member status, complications, clinical symptoms, progress of care plans, and any changes in condition.

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

• Collaborate with healthcare providers to facilitate services and treatments while revising care plans as needed.

• Collect, document, and maintain member information along with care management activities.

• Educate members and families/caregivers about disease processes, care gaps, provider instructions, care options, referrals, benefits, and community resources.

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

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

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

• Partner with leadership to enhance quality, service delivery, and cost-effectiveness.

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

• Carry out other assigned duties and adhere to policies and standards.

⛳️ Requirements

• Graduate from an accredited School of Nursing.

• 4 to 6 years of relevant experience.

• 4 to 6 years of clinical nursing experience in Pediatric Acute Care, Pediatric Home Health, or Pediatric Private Duty Nursing.

• RN state licensure and/or compact state licensure is required, or current state nurse licensure as a Nurse Practitioner.

• RUG certification must be obtained within 90 days of hiring for Superior.

• Background check by the Texas Department of Family & Protective Services (DFPS) is required.

• Travel for conducting member assessments is necessary.

• Flexibility to accommodate the school schedules of pediatric members when required.

• Bachelor of Nursing degree is preferred.

🏝️ Benefits

• Health insurance.

• 401K.

• Stock purchase plans.

• Tuition reimbursement.

• Paid time off plus holidays.

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

• Mileage reimbursement for member assessment visits.

• Total compensation may include additional forms of incentives.