LTSS Service Care Manager RN

Title - LTSS Service Care Manager-RN

Duration - 6 months

Shift - Monday - Friday 8am-5pm CST OT is unlikely but must be approved prior to working

Location - Remote Must live in Lubbock Tx and surrounding area

Payrate - $40 to $45 an hour

Note -

• Training Monday - Friday 8am-5pm CST 6 week course class room setting CAMERA ON NO TIME OFF DURING TRAINING
• In-home visits up to 3x a week
• Must have reliable transportation

Responsibilities:

• Day to day responsibilities include managing a complex member caseload conducting clinical and service coordination reviews completing required assessments participating in interdisciplinary collaboration and ensuring documentation meets regulatory standards.
• The role actively supports issue resolution provider coordination member and caregiver education and proactive identification of care gaps.
• Project involvement may include quality initiatives audit preparation activities process improvement efforts and pilot implementations tied to state or organizational priorities.
• Performance is measured through a combination of productivity quality and compliance metrics including:
• Timeliness of assessments authorizations and required outreach
• Documentation accuracy and audit outcomes
• Adherence to regulatory and contract requirements
• Caseload management and member engagement standards
• Participation in quality improvement and process initiatives
• Consistency reliability and audit readiness are critical performance expectations.
• This role is unique due to the high level of clinical judgment regulatory knowledge and cross functional collaboration required. It blends direct member impact with compliance driven responsibilities and provides exposure to complex Medicaid policy quality oversight and system wide initiatives. The role offers meaningful influence on member outcomes while supporting organizational performance in a highly regulated environment.

Education Required: Associates Requires Graduate from an Accredited School of Nursing or a Bachelors degree and 4 6 years of related experience

License Required: MUST have RN (TX)

Years of experience required: 2 years pediatrics experience case management RN required looking for someone that wants to grow their career at Client.

Disqualifiers: Gaps of employment position longevity

Top 3

• Work Motivated/Caseload/workload management/ follow processes and policies
• Advanced documentation/technical system proficiency
• Ability to independently interpret and apply policy ability to troubleshoot