Senior LTSS Service Care Manager (RN)

Experience with Long-Term Services and Supports (LTSS), Medicaid, managed care organizations (MCOs), or complex-care populations. By applying to our jobs you agree to receive calls, AI-generated calls, text messages, or emails from Pyramid Consulting, Inc. and its affiliates, and contracted partners.

Immediate need for a talented Senior LTSS Service Care Manager (RN). This is a 06+ Months Contract opportunity with long-term potential and is located in US (Remote). Please review the job description below and contact me ASAP if you are interested.

Job ID:26-32428

Pay Range: $40 - $44/hour.  Employee benefits include, but are not limited to, health insurance (medical, dental, vision), 401(k) plan, and paid sick leave (depending on work location).
 
Key Responsibilities:

• Review member medical records, diagnoses, medications, recent authorizations, and other relevant clinical information before scheduled visits.
• Conduct in-person assessments, including initial assessments, change-in-condition assessments, MDCP assessments, and Level 3 reassessments.
• Travel to members’ homes to complete comprehensive assessments, which may require up to two hours each way.
• Identify member needs and coordinate appropriate services to promote continuity of care.
• Submit completed assessments within 24 hours of the visit and initiate service requests within three business days, as applicable.
• Complete all other required documentation within five business days.
• Coordinate the transition of members to the appropriate permanent Care Manager or Service Coordinator, generally within 15 business days.
• Complete all required training through Client University by assigned deadlines.
• Manage assigned tasks, prioritize competing responsibilities, and meet established productivity, quality, and turnaround-time expectations.
• Collaborate with team members to address member needs and support effective care coordination.

Key Requirements and Technology Experience:

• Active Registered Nurse (RN) license.
• Minimum of three years of nursing experience.
• Minimum of two years of case management experience.
• Strong clinical assessment, critical-thinking, and decision-making skills.
• Excellent organizational, time-management, and documentation skills.
• Ability to prioritize multiple responsibilities, follow established procedures, and meet strict deadlines.
• Strong communication and interpersonal skills.
• Pediatrics experience.
• Home health or managed care experience.
• Experience with Long-Term Services and Supports (LTSS), Medicaid, managed care organizations (MCOs), or complex-care populations.
• Experience conducting in-home assessments and coordinating community-based services.
• Familiarity with electronic medical records and clinical documentation systems.

Our client is a leading Healthcare Industry and we are currently interviewing to fill this and other similar contract positions. If you are interested in this position, please apply online for immediate consideration.
 
Pyramid Consulting, Inc. provides equal employment opportunities to all employees and applicants for employment and prohibits discrimination and harassment of any type without regard to race, color, religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state or local laws.

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