LTSS Service Care Manager

Position Title: LTSS Service Care Manager

Work Location: Florida - 33156, 33157, 33158, 33189, 33142, 33166, 33172, 33126, 33125, 33145, 33155, 33144, 33147, 33192, 33141, 33139, 33154, 33140 MAY be able to accept one in the 33032, 33033 or 33183, 33193,33177

Assignment Duration: 12 Months (Possibility to extend or convert)

Work Schedule: Monday - Friday 8 am - 5 pm

Work Arrangement: Remote with fieldwork (80% travel)

Spanish speaking required

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.

Background & Context:

Role supports Sunshine State Health Plan with home and community-based services, including nursing home caseloads for geriatric long-term care members.

Team has anywhere from home and community caseload (home and community based & nursing home)

• Home 60 members
• Mixed would be 60-70 members
• The numbers may fluctuate based on business needs
• This role is remote but also requires field work - while allows for a self-made independent role.

They can build and schedule their meetings throughout the week

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.

* Must have Case management (2 years) Candidate Requirements

Education/Certification
Required: Requires a Bachelor's degree and 2 - 4 years of related experience

Preferred: n/a

Licensure
Required: n/a
Preferred: n/a

• Years of experience required
• Disqualifiers
• Best vs. average
• Performance indicators

Must have:

Case management (2 years)

Strong Microsoft skills

Nice to have

Bi-lingual or Tri-lingual would be great but must be able to communicate (verbal and written) in English as well. The members will have intakes in English, but should there be any language barriers that is why the team is seeking someone Bi-Lingual.

• Previous LTC or Hospice experience
• Bilingual - Spanish preferred with strong English skills
• Hialeah to North Miami - preferred. Also 33133, 33130, 33129, 33147

Previous interview feedback from HM on a general level:

1. candidates are lacking in answering questions from the team during the interview
2. Even though the team is seeking bi-lingual candidates - they are noticing that if English is not their first language, they may not be understanding the ask / question
3. The team needs to ensure the CW can provide adequate and sufficient feedback

Assessments to members will be completed in English - but with that they are looking to ensure comprehension

Best vs. average:

Someone with great time management and great communication and written skills to the hiring manager it is very important for this person to be a team player

Someone who is adaptable to change

Training is completed virtually and not everyone is a virtual learner - this person should know and be comfortable with that

• Top 3 must-have hard skills
• Level of experience with each
• Stack-ranked by importance
• Candidate Review & Selection

1

targeted case management is a good background to have

2

Case management is a great background to have

3

Strong Microsoft skills

Position is offered by a no fee agency.