Clinical - LTSS Service Care Manager

Location : This is a Remote / Member facing position. % of the time the Care Manager will be conducting home and / or facility visits with members.

Contractors will need to be from the Cameron County area, which includes the Harlingen and San Benito area. It is remote work from home, except those days they are doing visits

Shift : am to pm M-F with a possibility of OT

Job Description : "Position Purpose :

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.

Education / Experience :

Requires a Bachelor's degree and years of related experience.

Walk me through the day to day responsibilities of this the role and a description of the project :

• SC will have days of visits and days of documentation weekly
• SC will have a caseload and work assigned tasks
• SC will complete H assessment
• SC will fill put required forms for each assessment
• SC will make follow up calls

Describe the performance expectations / metrics for this individual and their team :

• Conduct in-home face to face member assessments and telephonic outreach
• Document assessments and contacts, develop and approve service plans, and ensure authorizations are completed
• Conduct follow-up contacts or in-person visits to determine if services meet member’s needs
• Assess member’s medical, safety and support service needs and coordinate the delivery of services
• Provide education related to member’s health condition and care
• Assist with modification and management of care plans under the direction of Registered Nurse in conjunction with member, medical consenter or caregiver, Department of Family and Protective Services caseworker and family, if applicable, as well as the managing physician
• Maintain case record documents and enter information in an automated system, establishing a record for each member receiving services
• Coordinate member care through collaboration with community outreach and member advocates, assigned service coordinators, and / or case managers
• Educate providers and community resources on program components and available support services
• Educate members to foster compliance with program and positively impact outcomes

travel required.

Required Skills / Experience : Preferred Skills / Experience : . Year Case Worker exprience . Bilingual . Working with the adult, blind and disabled community over the age of .

• Computer skills . Education Requirement : Licensed Vocational Nurse, Social Worker, Education Preferred : Bachelor’s degree in social work, Health Services, Behavioral Science or related field, or equivalent experience.
• years of experience in a managed care environment or working with people with disabilities and vulnerable populations who have chronic or complex conditions.

Software Skills Required : Microsoft Office with emphasis in Outlook, Excel Required Certifications : LPN, LVN, LCSW Required Testing :