LTSS Service Care Manager

Position Title : LTSS Service Care Manager

Work Location : Florida based candidates (must be within specific areas noted on each request and per the tracker shared with vendors. Lee county / Lehigh Acres region F8 Spanish speaking always preferred

Assignment Duration : 3 months with intent to convert

Work Schedule : 8-5 Mon-Fri

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 :

Health plan or business unit

Team culture

Surrounding team & key projects

Purpose of this team

Reason for the request

Motivators for this need

Any additional upcoming hiring needs?

The team has a strong longevity and many of the team have been a part of the team for years

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.

For Iowa Only : Bachelor's degree with 30 semester hours or equivalent quarter hours in a human services field (including, but not limited to, psychology, social work, mental health counseling, marriage and family therapy, nursing, education, occupational therapy, and recreational therapy) and at least two years of experience in the delivery of services to the population groups or current state's Registered Nurse (RN) license and at least four years of experience required

For North Carolina Standard Plan : Two (2) years of prior LTSS and / or HCBS coordination, care delivery monitoring and care management experience; Prior experience with social work, geriatrics, gerontology, pediatrics, or human services. RN or LCSW required.

For North Carolina Tailored Plan : Two (2) years of prior LTSS and / or HCBS coordination, care delivery monitoring and care management experience; Prior experience with social work, geriatrics, gerontology, pediatrics, or human services. RN or LCSW / LCSW-A preferred

Candidate Requirements :

Required : Requires a Bachelor's degree and 2 - 4 years of related experience. (Bachelors Degree should be within the realm of Healthcare) - Psychology, Sociology, etc.

Field experience would need to be long term to have the team consider someone that does not have a degree within the space they are looking for.

Required : Valid driver's license

Must haves :

2+ years of Care Management experience (field experience is a must)

Caseloads of 50,60,70 members - bonus if it is geriatric

Long Term Care Medicaid experience

Medicaid / Medicare experience

Need to see experience being able to manage high case load

Fast paced environment regarding new processes and programs

They must be comfortable being able to connect with IT should their equipment fail in the field, etc. or be able to go into an office location or IT space.

All documentation must be within system within 24 hours of completion

Experience with electronic medical health records

Home Health Experience

Nice to haves : Discharge Planning

Working with TruCare which is the software the team uses

Disqualifiers :

Not having field experience

Not having previous experience with high caseloads

Performance indicators :

Bilingual always preferred - req will indicate if Bilingual is required via the notes section

Top 3 must-have hard skills :

2 years of field case management

Technology Savy

Must be able to look at calendar and manage time - ensuring enough time for documentation

Position is offered by a no fee agency.