LTSS Service Care Manager

Position Title: LTSS Service Care Manager

Work Location: Florida based candidates (must be within specific areas noted on each request) All candidates must reside in Lehigh Acres County- bilingual Spanish is required

Will be in the field 80-90% of the time.

Assignment Duration: 12 months

Work Schedule: 8 AM-5 PM, Monday-Friday

Work Arrangement: Remote with extensive fieldwork (approximately 80-90% according to intake notes)

Position Summary:

Assists in developing, assessing, and coordinating holistic care management activities to enable quality, cost-effective healthcare outcomes. May 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.

Key Responsibilities:

• Evaluates the needs of the member, the resources available, and recommends and/or facilitates the plan for the best outcome

• Assists with developing ongoing long-term care plans/service plans and works to identify providers, specialist, and/or community resources needed for long-term care

• Coordinates as appropriate between the member and/or family/caregivers and the care provider team to ensure identified services are accessible to members

• Provides resource support to members and their families/caregivers for various needs (e.g. employment, housing, participant direction, independent living, justice, foster care) based on service assessment and plans

• Monitors care plans/service plans, member status and outcomes, as appropriate, and provides recommendations to care plan/service plan based on identified member needs

• Interacts with long-term care healthcare providers and partners as appropriate to ensure member needs are met

• Collects, documents, and maintains long-term care member information and care management activities to ensure compliance with current state, federal, and third-party payer regulators

• May perform home and/or other site visits to assess member's needs and collaborate with healthcare providers and partners

• Provides and/or facilitates education to long-term care members and their families/caregivers on procedures, healthcare provider instructions, service options, referrals, and healthcare benefits

• Provides feedback to leadership on opportunities to improve and enhance quality of care and service delivery for long-term care members in a cost-effective manner

• Performs other duties as assigned

• Complies with all policies and standards

Qualification & Experience:

• Requires a Bachelor's degree and 2 - 4 years of related experience.

• Or equivalent experience acquired through accomplishments of applicable knowledge, duties, scope and skill reflective of the level of this position.

  Candidate Requirements
  Education/Certification
  Required: Requires a Bachelor's degree and 2 - 4 years of related experience. (Bachelors Degree should be within the realm of Healthcare) - Psychology, Sociology, etc.
  Field experience would need to be long term to have the team consider someone that does not have a degree within the space they are looking for.
  Preferred: n/a
  Licensure
  Required: Valid driver's license
  Preferred: n/a
  • Years of experience required
  • Disqualifiers
  • Best vs. average
  • Performance indicators
  
  
  
  Must haves:
  • 2+ years of Care Management experience (field experience is a must)
  • Caseloads of 50,60,70 members - bonus if it is geriatric
  • Long Term Care Medicaid experience
  • Medicaid / Medicare experience
  • Need to see experience being able to manage high case load
  • Fast paced environment regarding new processes and programs
  • They must be comfortable being able to connect with IT should their equipment fail in the field, etc. or be able to go into an office location or IT space.
  • All documentation must be within system within 24 hours of completion
  • Experience with electronic medical health records
  • Home Health Experience
  
  
  
  Nice to haves:
  
  1. Discharge Planning
  2. Working with TruCare which is the software the team uses
  
  
  
  Disqualifiers:
  • Not having field experience
  • Not having previous experience with high caseloads
  
  
  
  Performance indicators: Bilingual always preferred - req will indicate if Bilingual is required via the notes section
  • Top 3 must-have hard skills
  • Level of experience with each
  • Stack-ranked by importance
  • Candidate Review & Selection
  
  
  
  
  
  1
  2 years of field case management
  2
  Technology Savy
  3
  Must be able to look at calendar and manage time - ensuring enough time for documentation