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LTSS Service Care Manager

LTSS Service Care Manager

Spectraforce TechnologiesWest Palm Beach, FL, United States
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Position Title : LTSS Service Care Manager

Work Location : Candidates must reside in West Palm Beach County - Boca Raton area. Zip Codes : 33428 33433 33434 33496 33498 33427 33429 33431 33432 33481 33486 33487 33488 33497 33499

Assignment Duration : 12 months

Work Schedule : Monday - Friday 8 am - 5 pm

Work Arrangement : This is a remote position working from a home office. The role is remote but also requires field work - while allows for a self-made independent role. Southern Palm Beach County is the target location.

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 :

  • Stabilizing Long term care workforce, supporting and maintaining compliance as we continue into our new contract requirements effective 2 / 1 / 25. We were awarded the entire state for the new state contract.
  • Opportunity for promoting and growth from within the company. Promotional opportunity who wants to grow within the company and continue to develop even across to other lines of business
  • We have a diverse team as our membership is diverse. Having a diverse workforce only helps the plan to better serve our members. The interview panel will consist of a diverse panel.
  • Prefer Spanish Speaking
  • The position will be 8 to 5 with the possibility of participating in a flex work week after bring hired on FTI ( to be reviewed / approved by leadership based on performance in the role)
  • The team has a strong longevity and many of the team have been a part of the team for years
  • They can build and schedule their meetings throughout the week
  • Interacting with members, family members, providers and other departments to ensure member's needs are being met. member / provider requests / issues / concerns
  • Visit members in field and return to home office to complete documentation .

managing difficult members, multiple priorities. Positive attitude, problem solver / solutions oriented, empathy while ensuring business needs are met.

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.

    License / Certification :

  • RN or LCSW / LCSW-A preferred
  • Required : Requires a Bachelor's degree and 2 - 4 years of related experience
  • Preferred : n / a
  • Required : Drivers License
  • Preferred : n / a
  • experience with field based case management, remote work, Average CL #, home visits, care plan development, experience with type of assessments.
  • ? 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
  • Prefer experience working with TruCare which is the software the team uses
  • Experience in Case Management in senior services, state agencies. Team Player, problem solver, solutions oriented, member centric, Integrity
  • 1 Field based case management
  • 2 Remote work
  • 3 Experience working with geriatric population
  • Position is offered by a no fee agency.

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    Care Manager • West Palm Beach, FL, United States

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