LTSS Service Care Manager

Job Title

Work Mode: Remote with in-person visits required, 3-4 days a week in the field Location: Guilford County, NC; Pitt County, NC; Cumberland County, NC Duration: 6 months, possible extension or conversion to permanent Shift: Training 8-5 Mon-Fri EST, work schedule 8-5 Mon-Fri EST

Responsibilities

Manage a case load for healthcare members with LTSS (Long Term Support/Services) needs Conduct monthly and quarterly member contact, involving 80% travel Complete assessments with members, caregivers, or providers to gather information 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 referrals for services Ensure provider services are delivered without gaps and identify deficiencies in care plans 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 and care plans Assist members with filing and resolving complaints and appeals

Requirements

Bachelor's degree required Licensed Clinical Social Worker/Registered Nurse License required Minimum 2 years of physical health care management experience Valid driver's license required Experience with Microsoft Office and electronic medical health records

Preferred Skills

4+ years of physical health care management experience preferred Experience in hospital CM, home health, discharge planning, or long-term care preferred Case management and care planning experience Home health experience, community health/member facing, discharge planning