Manager, LTSS Clinical Care Management

Manager, LTSS Clinical Care Management page is loaded## Manager, LTSS Clinical Care Management locations:
Dallas - 4001 McEwen Rd. Ste 300 (Superior) (10096):
Dallas - 4001 McEwen Rd. Ste 300 (Star Plus) (10108) time type:
Full time posted on:
Posted Todayjob requisition :
1629059

You could be the one who changes everything for our 28 million members. Centene is transforming the health of our communities, one person at a time. As a diversified, national organization, you’ll have access to competitive benefits including a fresh perspective on workplace flexibility.
** STAR Plus Waiver Program - Long Term Support Services
***
* Location:

Must reside in the DALLAS, TX area
**** RN Manager - LTSS Clinical Care Mgt - manage a team of RNs, Social Workers, and Support Staff. Travel is required.
**** Position

Purpose:

** Manages the care management team of licensed physical and/or behavioral health clinicians that serve long-term care members with physical/medical health needs and/or behavioral/mental health needs to develop and assess high quality, cost-effective healthcare outcomes. Manages escalations and care management issues related to members or providers.
* Oversees and reviews long-term care management required documentation to maintain compliance with federal and state regulations and contractual agreements
* Develops, implements, and oversees long-term care management policies and procedures within the long-term care management team based on regulatory requirements and industry standards
* Assigns, monitors and evaluates work assignments and caseloads of long-term care management staff based on state requirements, care management staff experience, and member needs
* Directs the daily activities of long-term care management staff including reviewing and approving the caseloads based on state requirements, care management staff experience, and member needs
* Manages escalated and complex care cases, and provides guidance to long-term care team members to address member concerns related to physical/medical health and/or mental/behavioral health needs
* May perform telephonic, digital, home and/or other site outreach to assess member needs and collaborate with resources
* Ensures proper coordination and communication of medical service functions with other departmental functions at the business as assigned
* Develops, implements, and oversees long-term care management programs to facilitate the use of appropriate services and resources
* Sets goals and objectives for long-term care management team to achieve cost-effective healthcare results
* Monitors audits within care management to ensure compliance with regulatory requirements for federal, state, and National Committee for Quality Assurance (NCQA) standards, as required
* Works with long-term care management senior management to provide updates and insights on care management team goals
* Reviews long-term care member data to identify trends and improve operating performance and quality care in accordance with state and federal regulations
* Provides coaching and guidance to long-term care management team to improve member and provider experience and facilitate delivery of high-quality care
* Educates and provides resources for long-term care management team on key initiatives and member outreach to facilitate on-going communication between care management team, members, and providers
* Assists long-term care management senior leadership with onboarding, hiring, and training long-term care management team members
* Leads and champions change within scope of responsibility
* Performs other duties as assigned
* Complies with all policies and standards
** Education/

Experience:

** Positions overseeing RN and BH team members:
Requires Graduate from an Accredited School of Nursing or a Bachelor's degree and 5+ years of related experience, or equivalent experience acquired through accomplishments of applicable knowledge, duties, scope and skill reflective of the level of this position.

*
* Preferred Experience:

*** 2+ years of People Leader experience or more is preferred.
* Highly advanced clinical knowledge and ability to assess member needs in context of relevant diagnoses,…