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Senior LTSS Service Care Manager, RN – Pediatrics
Centene CorporationRN care manager coordinating personalized long-term care for high-acuity pediatric members. Conducting Abilene-area home visits and connecting families with healthcare and community services.
Core Competencies
Role fitCore Competencies
Use this summary to align your resume positioning with the role.
Demonstrates expertise in care management for complex pediatric populations, including the development and monitoring of personalized care plans, regulatory compliance, and effective collaboration with healthcare teams. Proficient in educating members and families on care options and navigating community resources.
Highest-signal resume keywords
Registered Nurse LicensureCare Management ExperienceResource Utilization Group CertificationKnowledge of Healthcare RegulationsIn-Home Visit Coordination
ATS Keywords
Tailor your resumeApplicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard Skills
Care Plan DevelopmentClinical AssessmentMonitoring Clinical SymptomsDocumentation and ComplianceMember Advocacy
Soft Skills
CollaborationEducation and TrainingCommunication
Certifications & Qualifications
Registered Nurse LicensureResource Utilization Group Certification
Industry Keywords
Pediatric CareHigh-Acuity PopulationsLong-Term CareHealthcare ServicesCommunity Resources
About the role
Key responsibilities & impact- Assess and coordinate medical and supporting services across the continuum of care for complex/high-acuity pediatric populations
- Develop, monitor, and update personalized long-term care and service plans
- Evaluate member needs and recommend plans for optimal outcomes
- Collaborate with care management teams, healthcare providers, specialists, facilities, agencies, and community resources
- Coordinate person-centered care between members/families or caregivers and provider teams
- Monitor member status, complications, clinical symptoms, progress, and changes in condition
- Review referrals, intake assessments, and member data to develop care plans and improve quality and operating performance
- Collect, document, and maintain member and care management information for regulatory and clinical compliance
- Educate members and families/caregivers on disease processes, care gaps, provider instructions, care options, referrals, benefits, and community resources
- Act as liaison and member advocate between members/families, physicians, facilities, and agencies
- Coordinate service authorizations for services such as meals, employment, housing, foster care, transportation, and activities of daily living
- Perform home and other site visits, including visits once a month or more as required
- Partner with leadership to improve quality, service delivery, and cost effectiveness
- May precept, coach, and support clinical new hires and preceptees during onboarding
- Perform other assigned duties and comply with policies and standards
Requirements
What you’ll need- Graduate from an Accredited School of Nursing or a Bachelor's degree and 4–6 years of related experience
- Bachelor's degree in Nursing preferred
- RN — Registered Nurse — State Licensure and/or Compact State Licensure required, or NP — Nurse Practitioner — Current State's Nurse Licensure required
- Resource Utilization Group (RUG) certification must be obtained within 90 days of hire
- Clinical experience and knowledge in care management, long-term care, healthcare services, and high-acuity populations
- Ability to assess member needs and coordinate medical, supporting, and community services
- Knowledge of state and federal healthcare regulations and clinical guidelines
- Ability to conduct in-home and other site visits in the Abilene area
- Ability to educate members, families/caregivers, and providers on care options, benefits, referrals, and disease processes
Benefits
Comp & perks- Health insurance
- 401K plan
- Stock purchase plans
- Tuition reimbursement
- Paid time off plus holidays
- Flexible approach to work with remote, hybrid, field or office work schedules
- Potential additional forms of incentives
- Equal opportunity and diversity commitment