LTSS Service Care Manager

Location: Pitt County, NC
Work Mode: Remote with in-person visits
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, involving 80% travel.
• Complete assessments with members, caregivers, or providers to gather information for care plan development.
• Monitor the delivery of services and follow-up with members, caregivers, or providers through in-person visits and telephonic contact.
• Authorize and coordinate referrals 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 for integration into the member care plan.
• Collaborate with discharge planners, physicians, and other parties to ensure appropriate discharge and care plans.
• Assist members with filing and resolving complaints and appeals.

Requirements:

• Bachelor’s degree required.
• RN and/or LCSW/LCSW-A/BSN/ADN licensure required.
• Minimum 2 years of physical health care management experience.
• Valid driver's license required.

Preferred Skills:

• 4+ years of physical health care management experience preferred.
• Experience in hospital CM, home health, discharge planning, or long-term care preferred.
• Experience with case management and care planning.
• Tech-savvy with proficiency in Microsoft Office.
• Experience with electronic medical health records.