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Senior LTSS Service Care Manager (RN) - J01077

Axelon Services Corporation

McAllen, TX(remote)

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JOB DETAILS
JOB TYPE
Full-time
SKILLS
Acute Care, Case Management, Clinical Practices/Protocols, Clinical Support, Coaching, Disease, Federal Laws and Regulations, Health Plan, Healthcare Providers, Healthcare Quality, Identify Issues, Leadership, Long-Term Care, Maintain Compliance, Managed Care, Multilingual, Needs Assessment, Nursing Credentials, Onboarding, Pediatric Nursing, People Management, Performance Management, Presentation/Verbal Skills, Problem Solving Skills, QoS (Quality of Service), Quality Management, Quality of Care, Registered Nurse (RN), Risk, Service Delivery, State Laws and Regulations, Trend Analysis
LOCATION
McAllen, TX
POSTED
4 days ago
Location: Remote and in field visits are required, to the members homes - Candidates must reside in La Feria, TX & Harlingen, TX & San Benito, TX (or within Cameron County) 4-7 visits per week to members homes will be aware in advance (mileage/lodging will be reimbursed) May need to accommodate to members schedules for home visits May need to travel up to 2 hours away (rare but can happen) SHIFT: Training Mon Fri 8am -5pm CST 8 weeks CAMERAS ON NO TIME OFF for first 4 months Mon Fri 8am 5pm CST; with possible OT required. May need to stay late if needed may need to work a weekend if available No holidays Duration: This is a 6+ month, Temp to hire position. WILL NEED TO APPLY FOR THE FTE POSITION, will be based on performance Target Start Date: 6/8 or 6/22 starts Description: Job Profile Summary: CM will: Performs 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. Develops a personalized care plan / service plan for long-term care members, addresses issues, and educates members and their families/caregivers on services and benefit options available to receive appropriate high-quality care. Responsibilities Evaluates the service needs of the most complex or high risk/high acuity members and recommends a plan for the best outcome Develops and continuously assesses ongoing long-term care plans / service plans and collaborates with care management team to identify providers, specialists, and/or community resources needed to address member's needs Coordinates and manages 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 Monitors 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 Monitors 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 Reviews member data to identify trends and improve operating performance and quality care in accordance with state and federal regulations Reviews referrals information and intake assessments to develop appropriate care plans / service plans Collaborates with healthcare providers as appropriate to facilitate member services and/or treatments and determine a revised care plan for member if needed Collects, documents, and maintains all member information and care management activities to ensure compliance with current state, federal, and clinical guidelines Provides and/or facilitates 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 Acts as liaison and member advocate between the member/family, physician, and facilities/agencies Educates on and coordinates community resources. Provides 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 Partners 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 In field visits to the members homes - Candidates must reside in La Feria, TX & Harlingen, TX & San Benito, TX Candidate Requirements Education/Certification Required: Requires Graduate from an Accredited School of Nursing or a Bachelor's degree and 46 years of related experience Preferred: Bachelor's degree in Nursing preferred Licensure Required: RN - Registered Nurse - State Licensure and/or Compact State Licensure required Preferred: Years of experience required: 46 years of related experience case management, private duty nursing, pediatric population. Bilingual candidates needed. Disqualifiers: Non Bilingual RNs Additional qualities to look for: Top 3 must-have hard skills stack-ranked by importance 1 Communication written and verbal, 2 Problem solving/Navigating complex challenges/independent work/troubleshooting skills a must 3 Adaptability/Flexible (may need to accommodate to members schedules for home visits) reliable transportation

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Axelon Services Corporation