LTSS Service Care Manager

Job Title

Location: Wake County, NC or Charlotte, NC

Pay: Competitive, based on experience

Duration: 6 months with potential for extension or conversion to permanent

Shift: 8-5 Mon-Fri EST

Travel: 80% travel required

Responsibilities:

Assist in developing, assessing, and coordinating holistic care management activities

Enable quality, cost-effective healthcare outcomes

Develop or assist with developing personalized service care plans/service plans for long-term care members

Educate members and their families/caregivers on services and benefits available to meet member needs

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

Conduct monthly and quarterly member contact

Complete assessments with members, caregivers, or providers

Monitor delivery of services and follow-up with members, caregivers, or providers

Authorize and coordinate referral for services

Ensure provider services are delivered without gaps

Assist in coordinating the development of informal or voluntary services

Collaborate with discharge planners, physicians, and other parties

Assist member with filing and resolving complaints and appeals

Requirements:

Education/Certification: Required: Bachelor's

Licensure: Required: RN and/or LCSW/LCSW-A/BSN

Experience: 2-4 years of physical health care management experience required

Preferred: 4-6 years of physical health care management experience

Preferred Experience: Hospital CM, Home health, discharge planning, or long-term care experience

Home health experience

Required Skills:

RN and/or LCSW

Experience in physical hospital health, care management, utilization management, or home health

Proficiency in Microsoft Office

Preferred Skills:

Experience with Microsoft Office

Experience with electronic medical health records

Benefits:

Mileage and lodging reimbursed if needed

Valid driver's license required

Quarterly meetings: Once a quarter, attend a team meeting/training session