Clinical - LTSS Service Care Manager - J01031

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. The position provides valuable experience in member care planning and long-term care coordination, including developing service plans, connecting members with providers and community resources, and supporting long-term care needs across the continuum.

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: 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
Story Behind the Need
What is the purpose of this team? What is driving this need? (ex. Backfill for FTE or CW, new project, business growth) Describe the surrounding team (team culture, work environment, etc.) & key projects. Do you have any additional upcoming hiring needs, or is this request part of a larger hiring initiative?	Business Unit Carolina Complete Health Team Culture The team has a collaborative working style focused on coordination, support, and quality member care. Surrounding Team and Key Work This role works alongside Utilization management, Quality, Transition of care, care managers, coordinators, and navigators to support members across the care continuum. Purpose of the Team The team s purpose is to provide quality care management for members with complex medical needs while supporting effective and cost-conscious healthcare outcomes. Reason for the Request Additional LTSS care management coverage is needed to support members in region 2 counties of North Carolina. Primary Driver of the Need The need is driven by current caseload volume and business fluctuations. Upcoming Hiring Needs None identified at this time.
Typical Day in the Role
Walk me through the day-to-day responsibilities and a description of the project (Outside of the Workday JD). What are performance expectations/metrics? What makes this role unique?		Schedule This role follows an 8-hour day and a standard 40-hour work week. 8am-5pm EST Mon Friday Typical Responsibilities The day-to-day work includes developing, assessing, and coordinating holistic care management activities that support quality, cost-effective healthcare outcomes. The role may also involve creating or supporting personalized service plans for long-term care members and educating members, families, and caregivers about available services and benefits. Team Interaction The role is part of a collaborative team environment with regular coordination and communication. Work Environment This is primarily a remote role with face-to-face home visits with members. Occasional in-person team meetings. Could be > 50% travel What Makes This Role Interesting This role offers the opportunity to make a direct impact on members with complex medical needs by helping ensure they receive thoughtful, coordinated, and effective care. Team Culture The team has a collaborative, supportive environment focused on quality care management, strong coordination, and positive outcomes. Unique Value and Experience Gained The position provides valuable experience in member care planning and long-term care coordination, including developing service plans, connecting members with providers and community resources, and supporting long-term care needs across the continuum.