LTSS Service Care Manager

Location: 2 from Pitt County, NC; In-person visits 3-4 days a week in the field (up to 1-4 visits a day; if longer drive time, likely only 1 visit a day)
Work Mode: Remote role with 80% travel
Duration: 6 months, possible extension
Shift: Training 8-5 Mon-Fri EST – learning journey is 3.5 weeks – CAMERA ON – NO TIME OFF
Work schedule: 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.
• Complete assessments with members, caregivers, or providers to obtain information regarding client status, support system, and need for services 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.
• Assist in coordinating the development of informal or voluntary services to integrate into the member care plan.
• 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:

• Education: Required – Bachelor’s degree.
• Licensure: Required – RN and/or LCSW/LCSW-A/BSN/ADN.
• Minimum 2 years of physical health care management experience.
• Case management and care planning experience.
• Driver’s license required.

Preferred Skills:

• Home health experience, community health/member facing, discharge planning.
• Experience with Microsoft Office and electronic medical health records.
• Physical hospital health, care management, utilization management, home health background.