Clinical - LTSS Service Care Manager - J01031

Mindlance

Remote-DE, DE(remote)

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JOB DETAILS

SKILLS

Accounts Receivable, Background Investigation, Business Plan, Case Management, Diversity, Driver's License, Family Social Work, Geriatrics, Health Plan, Healthcare, Healthcare Providers, Leadership, Licensed Clinical Social Worker (LCSW), Long-Term Care, Maintain Compliance, Medical Treatment, Medications, Needs Assessment, Nursing, Occupational Therapy, Pediatrics, Psychiatry and Mental Health, Psychology, QoS (Quality of Service), Quality Management, Quality of Care, Reconciliation, Recreational Therapy, Registered Nurse (RN), Sales, Service Delivery, Social Work, Strategic Planning, Third-Party Payer, Willing to Travel

LOCATION

Remote-DE, DE(remote)

POSTED

5 days ago

Job Profile Summary
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 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:
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
For Arkansas Total Care plan - This position is designated as safety sensitive in Arkansas and requires a driver's license, child and adult maltreatment check (before hire and recurring), and a drug screen (at time of hire and recurring). Must reside in AR or border city. Travel: 5%. required

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

EEO:

Mindlance is an Equal Opportunity Employer and does not discriminate in employment on the basis of Minority/Gender/Disability/Religion/LGBTQI/Age/Veterans.

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Job Profile Summary 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 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: Delaware/Compact RN License 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
Story Behind the Need Business Group & Key Projects
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?		DFH PHCO- LTSS Position will be completing LTSS level of care redetermination and will be completing a mixture of care visits and supporting other LTSS case managers. Support the case management team due to high increase in membership. Level of care redeterminations, transition of care and Case management
Typical Day in the Role
Daily schedule & OT expectations Typical task breakdown and rhythm Interaction level with team Work environment description		Schedule is planned from Monday-Friday 8am 5pm \| No OT expectations Visit member homes
Compelling Story & Candidate Value Proposition
What makes this role interesting? Points about team culture Competitive market comparison Unique selling points Value added or experience gained		Able to assist members with immediate needs. Able to support LTSS team on maintaining members compliant with level of care redeterminations
Candidate Requirements
Education/Certification	Required: Bachelor's degree and 2 4 years of related experience.			Preferred:
Licensure	Required: Delaware/Compact RN License, Driver s license			Preferred:
Years of experience required Disqualifiers Best vs. average Performance indicators		Must haves: Driver s license, Home workspace \| Level of Care Redetermination, Transition of Care and Case Management experience Nice to haves: Service Care Manager Disqualifiers: Location should be within Delaware Performance indicators: 4-5 assessments per week, for redeterminations 4-5 daily
Top 3 must-have hard skills Level of experience with each Stack-ranked by importance Candidate Review & Selection		1	Computer literate
		2	Experience on evaluating older adults/disabled level of functioning
		3	Experience with medication reconciliation
Candidate Review & Selection
Shortlisting process Second touchpoint for feedback Interview Information Onboard Process and Expectations		Projected HM Candidate Review Date:			1-2 days post shortlisting
		Number and Type of Interviews:			1 MS Teams (panel of 2-3 interviewers)
		Extra Interview Prep for Candidate:
		Required Testing or Assessment (by Vendor):
Manager Communication Preferences & Next Steps
Background Check Requirements (List DFPS or other specialty checks here)
Do you have any upcoming PTO?
Colleagues to cc/delegate		Andrea Mifflin

Clinical - LTSS Service Care Manager - J01031

Mindlance

Remote-DE, DE(remote)

About the Company

Mindlance