LTSS Service Care Manager

Summary:

• Location: Pitt, Halifax, Northampton, Hertford, Warren, Washington counties, NC
• Work Mode: Remote 1-2 admin days a week, in-person visits 3-4 days a week in the field
• Duration: 6 months, with possible extension
• Shift: 8-5 Mon-Fri EST

Responsibilities:

• Manage a caseload for healthcare members with LTSS (Long Term Support/Services) needs
• Conduct monthly and quarterly member contact, including 80% travel
• Complete assessments with members, caregivers, or providers to gather information for care plan development
• Monitor delivery of services and follow up with members, caregivers, or providers through in-person visits and telephonic contact
• Authorize and coordinate referral for services
• Ensure provider services are delivered without gaps and identify functional deficiencies in plans of care
• Collaborate with discharge planners, physicians, and other parties to ensure appropriate discharge plan, care plan, and coordination of acute care and long-term care services
• Assist members with filing and resolving complaints and appeals

Requirements:

• Licensed Clinical Social Worker/Registered Nurse License
• Minimum 2 years of physical health care management experience
• Valid driver's license
• Experience in hospital CM, home health, discharge planning, or long-term care preferred

Preferred Skills:

• Home health experience, community health/member-facing, discharge planning
• Tech-savvy with Microsoft Office
• Experience with electronic medical health records