Axelon Services Corporation
Senior LTSS Service Care Manager (RN)
Axelon Services Corporation, Brownsville, Texas, United States, 78520
Job Title
Senior LTSS Service Care Manager (RN) Location
Remote with required field visits, Candidate physical Home Address must reside in Brownsville, TX or surrounding cities (i.e. Harlingen, Los Fresnos, Olmito) Pay
Competitive, based on experience Duration
6 months, possibility to extend or convert Targeted Start Date
February 17th Shift
Monday - Friday 8am - 5pm; with possible OT required. Job Description
Perform care management duties to assess and coordinate all aspects of medical and supporting services across the continuum of care for complex/high acuity populations with primary medical/physical health needs to promote quality, cost-effective care. Develop a personalized care plan/service plan for long-term care members, address issues, and educate members and their families/caregivers on services and benefit options available to receive appropriate high‑quality care. Typical Day in the Role
Evaluate the service needs of the most complex or high risk/high acuity members and recommend a plan for the best outcome. Develop and continuously assess ongoing long-term care plans/service plans and collaborate with care management team to identify providers, specialists, and/or community resources needed to address member's needs. Coordinate and manage as appropriate between the member and/or family/caregivers and the care provider team to ensure members are receiving adequate and appropriate person-centered care or services. Monitor care plans/service plans and/or member status, change in condition, and progress towards care plan/service plan goals; collaborate with member, caregivers, and appropriate providers to revise or update care plan/service plan as necessary to meet the member's goals/needs. Monitor member status for complications and clinical symptoms or other status changes, including assessment needs for potential entry into a higher level of care and/or waiver eligibility, as applicable. Review member data to identify trends and improve operating performance and quality care in accordance with state and federal regulations. Review referrals information and intake assessments to develop appropriate care plans/service plans. Collaborate with healthcare providers as appropriate to facilitate member services and/or treatments and determine a revised care plan for member if needed. Collect, document, and maintain all member information and care management activities to ensure compliance with current state, federal, and clinical guidelines. Provide and/or facilitate education to long-term care members and their families/caregivers on disease processes, resolving care gaps, healthcare provider instructions, care options, referrals, and healthcare benefits. Act as liaison and member advocate between the member/family, physician, and facilities/agencies. Educate on and coordinate community resources. Provide coordination of service authorization to members and care managers for various services based on service assessment and plans (e.g., meals, employment, housing, foster care, transportation, activities for daily living). May perform home and/or other site visits (e.g., once a month or more), such as to assess member needs and collaborate with resources, as required. Partner with leadership team to improve and enhance quality of care and service delivery for long-term care members in a cost-effective manner. May precept clinical new hires by fostering and building core skills, coaching and facilitating their growth, and guiding through the onboarding process to upskill readiness. May provide guidance and support to clinical new hires/preceptees in navigating within a Managed Care Organization (MCO) and provides coaching and shadowing opportunities to bridge gap between classroom training and field practice. Candidate Requirements
Education/Certification : Requires Graduate from an Accredited School of Nursing or a Bachelor's degree and 4-6 years of related experience. Bachelor's degree in Nursing preferred. Licensure : RN - Registered Nurse - State Licensure and/or Compact State Licensure required. Seniority level
Mid‑Senior level Employment type
Other Job function
Health Care Provider Industries: Staffing and Recruiting
#J-18808-Ljbffr
Senior LTSS Service Care Manager (RN) Location
Remote with required field visits, Candidate physical Home Address must reside in Brownsville, TX or surrounding cities (i.e. Harlingen, Los Fresnos, Olmito) Pay
Competitive, based on experience Duration
6 months, possibility to extend or convert Targeted Start Date
February 17th Shift
Monday - Friday 8am - 5pm; with possible OT required. Job Description
Perform care management duties to assess and coordinate all aspects of medical and supporting services across the continuum of care for complex/high acuity populations with primary medical/physical health needs to promote quality, cost-effective care. Develop a personalized care plan/service plan for long-term care members, address issues, and educate members and their families/caregivers on services and benefit options available to receive appropriate high‑quality care. Typical Day in the Role
Evaluate the service needs of the most complex or high risk/high acuity members and recommend a plan for the best outcome. Develop and continuously assess ongoing long-term care plans/service plans and collaborate with care management team to identify providers, specialists, and/or community resources needed to address member's needs. Coordinate and manage as appropriate between the member and/or family/caregivers and the care provider team to ensure members are receiving adequate and appropriate person-centered care or services. Monitor care plans/service plans and/or member status, change in condition, and progress towards care plan/service plan goals; collaborate with member, caregivers, and appropriate providers to revise or update care plan/service plan as necessary to meet the member's goals/needs. Monitor member status for complications and clinical symptoms or other status changes, including assessment needs for potential entry into a higher level of care and/or waiver eligibility, as applicable. Review member data to identify trends and improve operating performance and quality care in accordance with state and federal regulations. Review referrals information and intake assessments to develop appropriate care plans/service plans. Collaborate with healthcare providers as appropriate to facilitate member services and/or treatments and determine a revised care plan for member if needed. Collect, document, and maintain all member information and care management activities to ensure compliance with current state, federal, and clinical guidelines. Provide and/or facilitate education to long-term care members and their families/caregivers on disease processes, resolving care gaps, healthcare provider instructions, care options, referrals, and healthcare benefits. Act as liaison and member advocate between the member/family, physician, and facilities/agencies. Educate on and coordinate community resources. Provide coordination of service authorization to members and care managers for various services based on service assessment and plans (e.g., meals, employment, housing, foster care, transportation, activities for daily living). May perform home and/or other site visits (e.g., once a month or more), such as to assess member needs and collaborate with resources, as required. Partner with leadership team to improve and enhance quality of care and service delivery for long-term care members in a cost-effective manner. May precept clinical new hires by fostering and building core skills, coaching and facilitating their growth, and guiding through the onboarding process to upskill readiness. May provide guidance and support to clinical new hires/preceptees in navigating within a Managed Care Organization (MCO) and provides coaching and shadowing opportunities to bridge gap between classroom training and field practice. Candidate Requirements
Education/Certification : Requires Graduate from an Accredited School of Nursing or a Bachelor's degree and 4-6 years of related experience. Bachelor's degree in Nursing preferred. Licensure : RN - Registered Nurse - State Licensure and/or Compact State Licensure required. Seniority level
Mid‑Senior level Employment type
Other Job function
Health Care Provider Industries: Staffing and Recruiting
#J-18808-Ljbffr