LTSS Service Care Manager

Position Title:LTSS Service Care Manager

Work Location : 1 from Cumberland County, NC

NOTE FROM HM: MAKE SURE CANDIDATES ARE AWARE "Up to 2.5hr one way radius from home residence for face to face mbr visits... mileage and lodging (if needed) is reimbursed.

Assignment Duration : 6 months potential to extend/convert

Work Schedule: Training 8-5 Mon-Fri EST - learning journey is 3.5 weeks - CAMERA ON - NO TIME OFF (please ensure the candidates are aware they can't miss training) / Work schedule 8-5 Mon-Fri EST

Responsibilities:

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.

Managing a case load for healthcare members with LTSS (Long Term Support/Services) needs.

Monthly and quarterly member contact and will include 80% travel. Remote role. Will require a driver's license.

Member assessments and notes.

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 provider s 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.

Licensed Clinical Social Worker/Registered Nurse License and 2+ 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. Licenses/Certifications: Valid driver's license

Candidate Requirements

Required: Bachelor's
Preferred:

Required: RN and/or LCSW/LCSW-A/BSN/ADN
Preferred:

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

• 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