Senior LTSS Service Care Manager (RN) - J01077
Job Description
RN Care Manager - Complex Care
Job Type: Full-Time
About the Role
We are seeking a compassionate and experienced RN Care Manager to coordinate care for members with complex medical and long-term care needs. In this role, you will develop personalized care plans, collaborate with interdisciplinary healthcare teams, and advocate for members to ensure they receive high-quality, cost-effective, person-centered care across the continuum of care.
What You'll Do
- Assess high-risk and medically complex members to develop individualized care plans
- Coordinate services with physicians, specialists, caregivers, and community providers
- Monitor member progress, identify changes in condition, and update care plans as needed
- Educate members and caregivers on disease management, treatment options, healthcare benefits, and available community resources
- Review referrals, clinical assessments, and member data to improve care quality and outcomes
- Coordinate service authorizations and access to long-term care services, transportation, housing, meals, and other support programs
- Maintain accurate clinical documentation in compliance with state, federal, and organizational guidelines
- Conduct home and community visits when required to assess member needs
- Collaborate with interdisciplinary teams to improve quality, compliance, and member satisfaction
- Mentor and support newly hired clinical staff through onboarding, coaching, and clinical guidance as needed
- Active Registered Nurse (RN) license in the applicable state or Compact State License, or active Nurse Practitioner (NP) license
- Graduate of an accredited School of Nursing or Bachelor's degree with 4-6 years of related healthcare experience
- Experience in care management, case management, service coordination, or long-term care
- Experience managing complex or high-acuity patient populations
- Strong knowledge of care planning, clinical assessment, and healthcare coordination
- Excellent communication, documentation, organizational, and problem-solving skills
- Ability to work independently while managing multiple priorities
- Proficiency with electronic medical records and clinical documentation systems
- Bachelor of Science in Nursing (BSN)
- Experience in Managed Care, Medicaid, Medicare, or Long-Term Services and Supports (LTSS)
- Experience coordinating care for complex medical or behavioral health populations
- Resource Utilization Group (RUG) Certification or ability to obtain if required
- Experience mentoring, precepting, or training clinical staff
- Field-based position with periodic home and community visits
- Local travel may be required based on member needs
- Opportunity to improve healthcare outcomes for medically complex populations while working with a collaborative interdisciplinary team
If you're passionate about delivering compassionate, coordinated care and making a meaningful difference in the lives of members with complex healthcare needs, we'd love to hear from you. Apply today to join a team committed to improving health outcomes through exceptional care management.
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Meet Your Recruiter
Amit Singh
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