LTSS Service Care Manager

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.

Responsibilities:

• Evaluate the needs of the member, the resources available, and recommend and/or facilitate the plan for the best outcome.
• Assist with developing ongoing long-term care plans/service plans and work to identify providers, specialists, and/or community resources needed for long-term care.
• Coordinate as appropriate between the member and/or family/caregivers and the care provider team to ensure identified services are accessible to members.
• Provide 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.
• Monitor care plans/service plans, member status, and outcomes as appropriate, and provide recommendations to care plan/service plan based on identified member needs.
• Interact with long-term care healthcare providers and partners as appropriate to ensure member needs are met.
• Collect, document, and maintain long-term care member information and care management activities to ensure compliance with current state, federal, and third-party payer regulations.
• May perform home and/or other site visits to assess member’s needs and collaborate with healthcare providers and partners.
• Provide and/or facilitate education to long-term care members and their families/caregivers on procedures, healthcare provider instructions, service options, referrals, and healthcare benefits.
• Provide 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.
• Perform other duties as assigned.
• Comply with all policies and standards.

Requirements:

• Requires a Bachelor's degree and minimum 2 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 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: Minimum two 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: Minimum two 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.

Preferred Skills:

• Experience in the delivery of services to the population groups.
• Strong communication and coordination skills.