Senior LTSS Service Care Manager RN
Superior HealthPlan is looking for a Senior LTSS Service Care Manager RN to join our team in San Antonio, TX.
Responsibilities
Evaluate the service needs of complex/high acuity members and recommend the best plan.
Develop and continuously assess long‑term care plans, collaborating with the care management team to identify providers and community resources.
Coordinate and manage care between members, families and the care provider team to ensure person‑centered care.
Monitor care plans, member status and progress toward goals, updating plans as necessary.
Monitor member status for complications and clinical symptoms, assessing eligibility for higher‑level care.
Review member data to identify trends and improve operating performance and quality care.
Collaborate with healthcare providers to facilitate member services and determine revised care plans.
Maintain documentation of all member information and care management activities to ensure compliance with state, federal and clinical guidelines.
Provide education to members and families on disease processes, care options, referrals and benefits.
Act as liaison and advocate between members, families, physicians and facilities/agencies.
Coordinate community resources and service authorizations (e.g., meals, housing, transportation).
Perform home or site visits as required.
Partner with leadership to improve quality of care and service delivery cost‑effectively.
Precept clinical new hires, coaching and shadowing to bridge training and field practice.
Engage new hire/preceptee during onboarding, completing competency check points.
Engage in collaborative readiness process with People Leaders and cross‑functional teams.
Perform other duties as assigned and comply with all policies and standards.
Qualifications
Education/Experience
Graduate from an accredited nursing school or bachelor’s degree and 4–6 years of related experience.
RN or NP current state licensure.
License/Certification
Registered Nurse (RN) State Licensure or Compact State Licensure required.
Nurse Practitioner (NP) current state nurse licensure required.
Resource Utilization Group (RUG) certification obtained within 90 days of hire.
Location
Must reside in the San Antonio, TX area.
Pay Range
$35.49–$63.79 per hour.
Benefits
Competitive pay, health insurance, 401(k), stock purchase plans, tuition reimbursement, paid time off plus holidays, and flexible work schedules.
Equal Opportunity Employer
Centene is an equal‑opportunity employer committed to diversity. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, or other characteristics protected by applicable law.
Qualified applicants with arrest or conviction records will be considered in accordance with the LA County Ordinance and the California Fair Chance Act.