LTSS Service Care Manager

LTSS Service Care ManagerThe LTSS Service Care Manager assists in developing, assessing, and coordinating holistic care management activities to support quality, cost-effective healthcare outcomes. This role develops and manages personalized service care plans for Long-Term Services and Supports (LTSS) members and educates members and their families/caregivers on available services and benefits.This is a member-facing role requiring regular in-person visits, care coordination, assessments, and collaboration with healthcare providers and community resources.Responsibilities:Manage a caseload of healthcare members with Long-Term Support Services (LTSS) needs.Conduct member assessments and develop individualized care/service plans.Complete assessments with members, caregivers, and providers to understand client status, support systems, and service needs.Monitor delivery of services through in-person visits and telephonic follow-ups.Coordinate referrals and authorize services as needed.Ensure provider services are delivered without gaps and identify deficiencies in care plans.Collaborate with discharge planners, physicians, healthcare providers, and community partners.Support coordination of acute care and long-term care services.Assist members with complaints, appeals, and service-related concerns.Maintain accurate documentation and ensure compliance with state, federal, and payer regulations.Provide education to members and families regarding healthcare benefits, procedures, referrals, and service options.Identify opportunities to improve quality of care and service delivery.Field Requirements:Remote role with 1–2 administrative days per week.In-person member visits 3–4 days per week.Travel may include up to 2.5 hours one way from home residence.Mileage and lodging expenses reimbursed when applicable.Valid driver's license required.Required Qualifications:Bachelor’s degree required.RN or LCSW/LCSW-A required.2–4+ years of physical healthcare management experience required.4–6 years of experience preferred.Experience in hospital case management, home health, discharge planning, utilization management, or long-term care preferred.Preferred Experience:Community health/member-facing experience.Care planning and case management experience.Electronic Medical Records (EMR) experience.Strong Microsoft Office and technology skills.Required Skills:Physical healthcare management background.Care management/utilization management experience.Bedside case management experience.Strong communication and documentation skills.