Position Purpose:For use by Arizona, Superior, and Sunflower only.Performs care management duties to assess and coordinate all aspects of medical and supporting services across the continuum of care for complexhigh acuity populations with primary medicalphysical health needs to promote quality, cost effective care. Develops a personalized care plan service plan for longterm care members, addresses issues, and educates members and their familiescaregivers on services and benefit options available to receive appropriate highquality care.EducationExperience:Requires Graduate from an Accredited School or Nursing or a Bachelors degree and 46 years of related experienceBachelors degree in Nursing preferredLicenseCertification: RN Registered Nurse State Licensure andor Compact State Licensure required or NP Nurse Practitioner Current States Nurse Licensure required For Superior: Resource Utilization Group RUG certification requiredEvaluates the service needs of the most complex or high riskhigh acuity members and recommends a plan for the best outcome Develops and continuously assesses ongoing longterm care plans service plans and collaborates with care management team to identify providers, specialists, andor community resources needed to address members needs Coordinates and manages as appropriate between the member andor familycaregivers and the care provider team to ensure members are receiving adequate and appropriate personcentered care or services Monitors care plans service plans andor member status, change in condition, and progress towards care plan service plan goals collaborate with member, caregivers, and appropriate providers to revise or update care plan service plan as necessary to meet the members goals needsMonitors member status for complications and clinical symptoms or other status changes, including assessment needs for potential entry into a higher level of care andor waiver eligibility, as applicableReviews member data to identify trends and improve operating performance and quality care in accordance with state and federal regulationsReviews referrals information and intake assessments to develop appropriate care plans service plansCollaborates with healthcare providers as appropriate to facilitate member services andor treatments and determine a revised care plan for member if neededCollects, documents, and maintains all member information and care management activities to ensure compliance with current state, federal, and clinical guidelines Provides andor facilitates education to longterm care members and their familiescaregivers on disease processes, resolving care gaps, healthcare provider instructions, care options, referrals, and healthcare benefitsActs as liaison and member advocate between the memberfamily, physician, and facilitiesagenciesEducates on and coordinates community resources. Provides coordination of service authorization to members and care managers for various services based on service assessment and plans e.g., meals, employment, housing, foster care, transportation, activities for daily living May perform home andor other site visits e.g., once a month or more, such as to assess member needs and collaborate with resources, as requiredPartners with leadership team to improve and enhance quality of care and service delivery for longterm care members in a costeffective mannerMay precept clinical new hires by fostering and building core skills, coaching and facilitating their growth, and guiding through the onboarding process to upskill readiness May provide guidance and support to clinical new hirespreceptees in navigating within a Managed Care Organization MCO and provides coaching and shadowing opportunities to bridge gap between classroom training and field practiceMay engage and assist New HirePreceptee during onboarding journey including responsibility for completing competency check points ensuring readiness for Service Coordination successEngages in a collaborative and ongoing process with People Leaders and cross functional teams to measure and monitor readinessPerforms other duties as assignedComplies with all policies and standards 

About Us: Established in 2004, SPECTRAFORCE® is one of the largest and fastest-growing diversity-owned staffing firms in the US. The growth of our company is a direct result of our global client service delivery model that is powered by our state-of-the-art A.I. proprietary talent acquisition platform, robust ISO 9001:2015/ISO 27001 certified processes, and strong and passionate client engaged teams. We have built our business by providing talent and project-based solutions, including Contingent, Permanent, and Statement of Work (SOW) services to over 140 clients in the US, Canada, Puerto Rico, Costa Rica, and India. Key industries that we service include Technology, Financial Services, Life Sciences, Healthcare, Telecom, Retail, Utilities and Transportation. SPECTRAFORCE is built on a concept of “human connection,” defined by our branding attitude of NEWJOBPHORIA®, which is the excitement of bringing joy and freedom to the work lifestyle so our people and clients can reach their highest potential. Learn more at: http://www.spectraforce.com
 
Benefits: SPECTRAFORCE offers ACA compliant health benefits as well as dental, vision, accident, critical illness, voluntary life, and hospital indemnity insurances to eligible employees. Additional benefits offered to eligible employees include commuter benefits, 401K plan with matching, and a referral bonus program. SPECTRAFORCE provides unpaid leave as well as paid sick leave when required by law.

Equal Opportunity Employer: SPECTRAFORCE is an equal opportunity employer and does not discriminate against any employee or applicant for employment because of race, religion, color, sex, national origin, age, sexual orientation, gender identity, genetic information, disability or veteran status, or any other category protected by applicable federal, state, or local laws. Please contact Human Resources at LOA@spectraforce.com if you require reasonable accommodation.
 
California Applicant Notice: SPECTRAFORCE is committed to complying with the California Privacy Rights Act (“CPRA”) effective January 1, 2023; and all data privacy laws in the jurisdictions in which it recruits and hires employees. A Notice to California Job Applicants Regarding the Collection of Personal Information can be located on our website. Applicants with disabilities may access this notice in an alternative format by contacting NAHR@spectraforce.com.
 
LA County, CA Applicant Notice: If you are selected for this position with SPECTRAFORCE, your offer is contingent upon the satisfactory completion of several requirements, including but not limited to, a criminal background check. We consider qualified applicants with arrest or conviction records for employment in accordance with all local ordinances and state laws, including the Los Angeles County Fair Chance Ordinance for Employers (FCO) and the California Fair Chance Act (FCA). The background check assessment will consider whether a criminal history could reasonably have a direct, adverse impact on the job-related safety, security, trust, regulatory compliance, or suitability for this role. Such findings may result in withdrawal of a conditional job offer. 


At SPECTRAFORCE, we are committed to maintaining a workplace that ensures fair compensation and wage transparency in adherence with all applicable state and local laws. This position’s starting pay is: $9.50/hr.