Registered Nurse Care Manager LTSS

Job Title:Registered Nurse Care Manager – LTSS

Location: Must live in NC - 2.5-2.75 hr one way radius from home residence for face-to-face member visits

Pay: Mileage and lodging (if needed) is reimbursed

Shift:

• Training: 8-5 Mon-Fri EST – learning journey is 4 weeks – CAMERA ON – NO TIME OFF
• Work schedule after training: 8-5 Mon-Fri EST

Duration:

• 6 months, possible extension or conversion

Expected Start Date:

• 3/23/26 (Can start earlier if BGC is cleared in time)

Description:

• Managing a case load for healthcare members with LTSS (Long Term Support/Services) needs
• Monthly and quarterly member contact, includes 80% travel
• Remote role requiring a driver’s license
• Conduct member assessments and document notes
• Complete assessments with members, caregivers, or providers for care plan development
• Monitor delivery of services and follow-up with members, caregivers, or providers through in-person visits and telephonic contact
• Authorize and coordinate referrals for services
• Ensure provider services are delivered without gaps and identify functional deficiencies in plans of care
• Assist in the development of informal or voluntary services to integrate into the member care plan
• Collaborate with discharge planners, physicians, and other parties to ensure appropriate discharge and care plans
• Assist members with filing and resolving complaints and appeals

Requirement:

• Licensed Clinical Social Worker/Registered Nurse License
• 2 years of physical health care management experience required, 4-6 years preferred
• Experience in hospital CM, home health, discharge planning, or long-term care preferred
• Valid driver's license

Candidate Requirements:

• Education/Certification: Required: Bachelor’s
• Licensure: Required: RN
• Years of experience required: 2-4 years of physical health care management experience, 4-6 years preferred
• Home health experience

Disqualifiers:

• No Psych experience such as counseling
• No candidates right out of nursing school
• No Nursing homes or rehab experience

Additional Qualities to Look For:

• Experience with Microsoft Office
• Experience with electronic medical health records

Top 3 Must-Have Hard Skills:

• RN Physical hospital Health, Care Management, Utilization Management, Home Health – all and/or background
• Microsoft Office proficiency
• Bedside care management