Clinical Senior LTSS Service Care Manager (RN)

Job Description:

Title: Senior LTSS Service Care Manager (RN)
Position Type: Contract (6 Months) Potential Extension/Conversion
Location: Hybrid Austin Texas Area
Schedule: Monday Friday 8:00 AM 5:00 PM CST (OT may be required)
XXXX: XXXXXXXXXXX - XXXXXXXXXXX/hr. on w2.

Position Overview

Seeking an experienced Registered Nurse (RN) to join the STAR Kids Assessment Team as a Senior LTSS Service Care Manager. This role focuses on conducting comprehensive assessments for pediatric Medicaid members enrolled in the STAR Kids program to identify unmet healthcare needs and determine eligibility for Medicaid services and community-based support programs.

The position combines remote work with field-based member visits and requires strong case management assessment care coordination and documentation skills.

About the Team

The STAR Kids Assessment Team conducts initial assessments for newly enrolled pediatric members. The team evaluates medical behavioral developmental and social needs to ensure members receive appropriate Medicaid services and support.

The team operates in a highly collaborative remote environment utilizing Microsoft Teams for ongoing communication and support. Leadership maintains an open-door policy and provides continuous guidance and assistance.

Key Responsibilities

Member Assessment & Care Management

• Conduct comprehensive in-home assessments for pediatric STAR Kids members.
• Evaluate medical behavioral developmental and social service needs.
• Identify unmet healthcare needs and appropriate Medicaid-funded services.
• Develop individualized care plans based on assessment findings.
• Coordinate services with providers caregivers community resources and interdisciplinary teams.
• Monitor member progress and ensure appropriate service utilization.

Documentation & Compliance

• Complete detailed assessment documentation within required turnaround times.
• Maintain compliance with Medicaid state and organizational requirements.
• Ensure all documentation meets quality and regulatory standards.
• Meet performance expectations related to documentation accuracy and timeliness.

Field-Based Member Visits

• Conduct approximately six member visits per week.
• Travel from home office to members homes throughout the assigned service area.
• Manage scheduling and coordination of member appointments.
• Accommodate afternoon appointments that may occasionally extend beyond standard business hours.

Team Collaboration

• Participate in team meetings training sessions and case discussions.
• Collaborate with Team Leads and clinical leadership regarding complex cases.
• Maintain ongoing communication through remote collaboration tools.

Typical Weekly Schedule

• Approximately 3 days conducting member visits (2 visits per day).
• Approximately 2 days dedicated to documentation and case management activities.
• Heavy documentation workload with strict completion timelines.
• Performance metrics include:
  • Documentation quality and timeliness
  • Training compliance
  • Company performance goals
  • Assessment completion requirements

Required Qualifications

Education

• Associate Degree in Nursing (ADN) Bachelor of Science in Nursing (BSN) or Master of Science in Nursing (MSN)

Licensure

• Active Registered Nurse (RN) License

Experience

• Minimum 3 years of nursing experience
• Minimum 2 years of case management experience

Preferred Qualifications

• Home Health experience
• Pediatric nursing experience
• Medicaid or Managed Care experience
• Long-Term Services and Supports (LTSS) experience
• Community-based care coordination experience

Top Required Skills

1. Exceptional Organizational Skills
2. Strong Time Management Abilities
3. Effective Communication Skills

Work Environment

• Remote home office based
• Frequent travel to member homes within assigned territory
• Pediatric member population
• Collaborative virtual team environment
• Independent work with strong leadership support

Compliance Requirements

• Active RN License Verification Required
• Valid Drivers License Required
• Motor Vehicle Record (MVR) Check Required
• Must be authorized to work in the United States without sponsorship now or in the future

Additional Information

• This is a new position supporting the Plan STAR Kids Program.
• Opportunity for contract extension and potential long-term conversion.
• Candidates must be comfortable with both remote work and community-based member visits.