Professional Management Enterprises-posted about 2 months ago
Full-time • Mid Level
Remote • South Bend, IN
101-250 employees

We are seeking a dynamic and experienced LTSS Service Coordinator - RN Clinician to join our team. In this role, you will be responsible for the overall management of members' cases, providing supervision and direction to non-RN clinicians while ensuring compliance with applicable state laws and contracts. You will conduct clinical assessments, develop individual care plans, and coordinate care to meet the diverse needs of our members. This position does require ~ 50% travel (mileage is reimbursable), all other work is remote.

  • Manage members' cases within the scope of licensure, providing supervision and direction to non-RN clinicians.
  • Conduct telephonic or face-to-face clinical assessments to identify and evaluate members' needs, including physical health, behavioral health, social services, and long-term services and supports.
  • Identify members at high risk for complications and coordinate care in collaboration with the health care team.
  • Develop, monitor, evaluate, and revise individualized care plans to optimize member health across the care continuum.
  • Establish short- and long-term goals in collaboration with members, caregivers, family, and physicians.
  • Identify members who would benefit from alternative levels of care or waiver programs.
  • Assist in the implementation of member care plans by facilitating authorizations/referrals for services.
  • Interface with Medical Directors, Physician Advisors, and Inter-Disciplinary Teams on care management treatment plans.
  • Direct and/or supervise the work of non-RN clinicians, ensuring tasks are assigned appropriately and performance is reviewed regularly.
  • Registered Nurse (RN) with a minimum of 3 years of experience in working with individuals with chronic illnesses, co-morbidities, and/or disabilities in a Service Coordinator, Case Management, or similar role.
  • Current, unrestricted RN license in Indiana.
  • MA/MS in Health/Nursing preferred.
  • State-specified certification based on state law and/or contract may be required.
  • Training, expertise, and experience in providing case management and care coordination services for individuals, including specialized populations such as older adults and/or individuals with physical or developmental disabilities and/or individuals determined to have a serious mental illness (SMI).
  • Strong communication, organizational, and problem-solving skills.
  • Ability to work effectively in a collaborative team environment.
  • MA/MS in Health/Nursing preferred.
  • Health, dental, vision and supplemental insurance
  • 401k
  • 80 hours of PTO
  • 10 paid holidays
  • Reimbursable mileage
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