LTSS Service Care Manager

Position Title: LTSS Service Care Manager

Work Location: Member-Facing - Rocky Mount, NC

Assignment Duration: 6 months

Work Schedule: 8-5 Mon-Fri EST

NOTE FROM HM: "2.5-2.75 hr one way radius from home residence for face to face mbr visits... mileage and lodging (if needed) is reimbursed.

Position Summary: Assists in developing, assessing, and coordinating holistic care management activities to enable quality, cost-effective healthcare outcomes. Will develop or assist with developing personalized service care plans/service plans for long-term care members and educate members and their families/caregivers on services and benefits available to meet member needs.

Key Responsibilities:

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  Managing a case load for healthcare members with LTSS (Long Term Support/Services) needs.

  
  
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  Monthly and quarterly member contact and will include 80% travel. Remote role. Will require a driver's license.

  
  
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  Member assessments and notes.

  
  
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  Complete assessments with members, caregivers, or providers to obtain information regarding client status, support system, and need for services for care plan development.

  
  
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  Monitor delivery of services and follow-up with members, caregivers, or providers through in person visits and telephonic contact

  
  
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  Authorize and coordinate referral for services.

  
  
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  Ensure provider services are delivered without gaps and identify functional deficiencies in plans of care.

  
  
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  Assist in coordinating the development of informal or voluntary services to integrate into the member care plan

  
  
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  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 member with filing and resolving complaints and appeals.

?Qualification & Experience:

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  Education/Certification: Required: Bachelor's

  
  
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  Licensure: Required: RN and/or LCSW/LCSW-A/BSN

  
  
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  Years of experience required: 2-4+ years of physical health care management experience, 4-6+ years of physical health care management experience preferred. Hospital CM, Home health, discharge planning, or long-term care experience preferred.

  
  
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  Home health experience

  
  
• Licenses/Certifications: Valid driver's license

?Top 3 must-have hard skills stack-ranked by importance:

1. 
   

   RN and/or LCSW Physical hospital Health, Care Management, Utilization Mgt, Home Health - all and/or background

   
   
2. 
   

   Microsoft office

   
   
3. Bedside care management