Service Manager Jobs

About The Position

Requirements

• Graduate of an accredited school of nursing or a bachelor's degree and 4–6 years of related experience.
• Pediatric experience required.
• Must be licensed and reside in the San Antonio, Texas area.
• Current RN state licensure and/or compact state licensure, or current state nurse licensure as a Nurse Practitioner, required.
• Resource Utilization Group (RUG) certification required within 90 days of hire.

Nice To Haves

• Bachelor's degree in Nursing preferred.

Responsibilities

• Evaluate the service needs of complex or high-risk/high-acuity members and recommend a plan for the best outcome.
• Develop and continuously assess long-term care plans and service plans; collaborate with the care management team to identify providers, specialists, and community resources.
• Coordinate between members or their families/caregivers and the care provider team to ensure adequate, appropriate, person-centered care and services.
• Monitor care plans, member status, changes in condition, and progress toward goals; collaborate with members, caregivers, and providers to revise plans as needed.
• Monitor for complications, clinical symptoms, or other status changes, including potential need for a higher level of care or waiver eligibility.
• Review member data to identify trends and improve operating performance and quality of care in accordance with state and federal regulations.
• Review referral information and intake assessments to develop appropriate care plans and service plans.
• Collaborate with healthcare providers to facilitate services or treatments and determine revised care plans when needed.
• Collect, document, and maintain member information and care management activities in compliance with state, federal, and clinical guidelines.
• Provide or facilitate education for members and families/caregivers about disease processes, care gaps, provider instructions, care options, referrals, and healthcare benefits.
• Act as a liaison and member advocate between members or families, physicians, and facilities or agencies.
• Educate members on and coordinate community resources.
• Coordinate service authorizations for services such as meals, employment, housing, foster care, transportation, and activities of daily living.
• Conduct home or other site visits, potentially once a month or more, to assess member needs and collaborate with resources, as required.
• Partner with leadership to improve quality of care and service delivery for long-term care members in a cost-effective manner.
• May precept clinical new hires by coaching, building core skills, facilitating growth, and supporting onboarding.
• May guide and support clinical new hires or preceptees in navigating a Managed Care Organization and provide coaching and shadowing to bridge classroom training and field practice.
• May assist new hires or preceptees during onboarding, including completing competency checkpoints and assessing readiness for service coordination.
• Work collaboratively with People Leaders and cross-functional teams to measure and monitor readiness.
• Perform other duties as assigned and comply with all policies and standards.

Benefits

• Competitive pay
• Health insurance
• 401(k)
• Stock purchase plans
• Tuition reimbursement
• Paid time off
• Paid holidays
• Flexible approach to work, with remote, hybrid, field, or office work schedules
• Additional forms of incentives may be included in total compensation