Job Description

Below mentioned is the job description for your reference:

Job Title: Clinical - Senior LTSS Service Care Manager (RN)

Location: Remote - McAllen, and/or Austin TX

Duration: 6 months (possible extension)

Shift: 8am-5pm for scheduled visits, may need to work after 5pm to complete documentation. No overtime.

Job Responsibilities:

• Review/research assigned members
• Contact the member the day before to confirm visit and set up telehealth meeting invite
• Explain to member that the visit may take anywhere between 2-3 hours
• Perform assessment either via telehealth (video AND audio) or in-person (in member's home)
• Contact PCP office to confirm diagnosis and report any abnormal findings
• Upload the MN signature page within 1 business day for attempts to MD signature to begin
• Complete the assessment documentation
• Coordinate assessment finding needs ex-send referrals for DME items covered under the member's core benefit, initiate non-waiver items/services
• Once the MD signature is received-assessing RN is to sign the MNLOC (assessment) within 24 hours
• Process continues from this point as needed

Describe the performance expectations/metrics for this individual and their team:

• Meet contractual requirement for each assessment to be completed within 45 calendar days
• In order to meet the contractual requirements of 45 days internal TAT needs to be met

What makes your team/department/culture special that you would like candidates to know?

• We are a statewide team, but help each other when needed-teamwork

Required:

• Previous Hospice, Home Health or Service Coordination experience preferred.
• Basic computer knowledge and accurate typing
• Flexibility
• Reliable transportation/ VALID DL (No company car)

Additional Notes:

• ONLY submit candidates who have been FULLY VACCINATED
• CM will be reimbursed for mileage
• CM will need to come in office if additional coaching is needed or performance issues arise

Education Requirement:

• RN

Software Skills Required:

• Have experience with computer charting and know how to navigate all products of Microsoft.

Required Certifications:

• Current TX RN license with no stipulations, will have to get RUG certification once hired- reimbursable

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