LTSS Service Care Manager

Position Title LTSS Service Care Manager Work Location Cumberland County, NC (up to 2.5-hour one-way radius from home residence for face-to-face member visits; mileage and lodging reimbursed if needed) Assignment Duration 6 months (possibility to extend or convert) Work Schedule ongoing work schedule 8-5 Mon-Fri EST Training Schedule Training 8-5 Mon-Fri EST (3.5 weeks, cameras on, no time off) Work Arrangement Hybrid - Remote 1-2 admin days per week; in-person member visits 3-4 days per week in the field (up to 1-4 visits per day; longer drive times may mean only 1 visit/day) Quarterly team meetings/training at Raleigh or Charlotte office locations. Position Summary Assists in developing, assessing, and coordinating holistic care management activities to enable quality, cost-effective healthcare outcomes. Will develop or assist with developing personalized service care plans/service plans for long-term care members and educates members and their families/caregivers on services and benefits available to meet member needs. Member facing but potentially provider facing. Key Responsibilities Managing a case load for healthcare members with LTSS (Long Term Support/Services) needs. Monthly and quarterly member contact and will include 80% travel. Complete assessments with members, caregivers, or providers to obtain information regarding client status, support system, and need for services for care plan development. Monitor delivery of services and follow-up with members, caregivers, or providers through in person visits and telephonic contact. Authorize and coordinate referral for services. Ensure provider services are delivered without gaps and identify functional deficiencies in plans of care. Assist in coordinating the development of informal or voluntary services to integrate into the member care plan. Collaborate with discharge planners, physicians, and other parties to ensure appropriate discharge plan, care plan, and coordination of acute care and long-term care services. Assist member with filing and resolving complaints and appeals. Education / Certification Required: Bachelor's Preferred: Licensure Required: RN and/or LCSW/LCSW-A/BSN/ADN Preferred: Experience Years of experience required: 2-4+ years of physical health care management experience, 4-6+ years of physical health care management experience preferred. Hospital CM, Home health, discharge planning, or long-term care experience preferred. Case management and care planning experience. Preferred - Home health experience, community health/member facing, discharge planning Disqualifiers: No Psych experience such as counseling (must have bedside case management hospital physical as well) no Right out of nursing school. No Nursing homes. No rehab. Additional qualities to look for: Virtual, All Microsoft office, Experience with electronic medical health records Key Skills Top 3 must-have hard skills stack-ranked by importance 1 Physical hospital Health, Care Management, Utilization Mgt, Home Health - all and/or background 2 Microsoft office - Tech savvy 3 Bedside care management #J-18808-Ljbffr