New

Senior LTSS Service Care Manager (RN)

Spectraforce Technologies
United States, North Carolina, Raleigh
Mar 13, 2025
Job Title: Senior LTSS Service Care Manager (RN) Job Location: Member Facing - McAllen area and will cover Corpus Christi as well Job Duration: 6 Months Shift: 8 am-5 pm CST Monday-Friday with an hour lunch, Late visits or weekend visits may be needed if a family requests, which may result in OT. Responsibilities: Day to day, task change regularly, you may be doing home visits in the field or you may be working on telephonic follow ups from your home office. We carry caseloads around 65 cases and have expectations to manage both field visits done quarterly with telephonic outreaches done monthly. Some needs may need daily follow up or even follow up multiple times a day with different departments depending on what it is. Each day varies and keeps the role interesting and ever changing. Must haves: 2+ years of clinical nursing experience in a clinical, acute care, or community setting and 1+ years of case management experience in a managed care setting. Knowledge of utilization management principles and healthcare managed care. Experience with medical decision support tools (i.e. Interqual, NCCN) and government sponsored managed care programs Nice to haves: 2+ years of clinical nursing or case management experience in a clinical, acute care, managed care or community setting. 2+ years experience working with people with disabilities and vulnerable populations who have chronic or complex conditions in a managed care environment. Experience with medical decision support tools (i.e. Interqual, NCCN) and government sponsored managed care programs. Other state specific requirements may apply.