["LTSS Service Care Manager","LTSS Service Care Manager"]

Position Title: LTSS Service Care Manager

Work Location: North Port or Port Charlotte area, Florida

Assignment Duration: 3 months (Possibility to extend or convert)

Work Schedule: 8-5 Mon-Fri

Work Arrangement: Hybrid (Remote with 80-90% field work)

Position 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.

Background & Context:

Role supports Sunshine State Health Plan long-term care members with significant field-based member interaction.

Key Responsibilities:

* Evaluates the needs of the member, the resources available, and recommends and/or facilitates the plan for the best outcome

* Assists with developing ongoing long-term care plans/service plans and works to identify providers, specialist, and/or community resources needed for long-term care

* Coordinates as appropriate between the member and/or family/caregivers and the care provider team to ensure identified services are accessible to members

* Provides 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

* Monitors care plans/service plans, member status and outcomes, as appropriate, and provides recommendations to care plan/service plan based on identified member needs

* Interacts with long-term care healthcare providers and partners as appropriate to ensure member needs are met

* Collects, documents, and maintains long-term care member information and care management activities to ensure compliance with current state, federal, and third-party payer regulators

* May perform home and/or other site visits to assess member's needs and collaborate with healthcare providers and partners

* Provides and/or facilitates education to long-term care members and their families/caregivers on procedures, healthcare provider instructions, service options, referrals, and healthcare benefits

* Provides 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

* Performs other duties as assigned

* Complies with all policies and standards

Qualification & Experience:

* Requires a Bachelor's degree and 2 - 4 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 (including, but not limited to, psychology, social work, mental health counseling, marriage and family therapy, nursing, education, occupational therapy, and recreational therapy) 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: Two (2) 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: Two (2) 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

Candidate Requirements

Required: Requires a Bachelor's degree and 2 - 4 years of related experience. (Bachelors Degree should be within the realm of Healthcare) - Psychology, Sociology, etc.

Field experience would need to be long term to have the team consider someone that does not have a degree within the space they are looking for.
Preferred: n/a

Required: Valid driver's license
Preferred: n/a

• Years of experience required
• Disqualifiers
• Best vs. average
• Performance indicators
• 
  

Must haves:

• 2+ years of Care Management experience (field experience is a must)
• Caseloads of 50,60,70 members - bonus if it is geriatric
• Long Term Care Medicaid experience
• Medicaid / Medicare experience
• Need to see experience being able to manage high case load
• Fast paced environment regarding new processes and programs
• They must be comfortable being able to connect with IT should their equipment fail in the field, etc. or be able to go into an office location or IT space.
• All documentation must be within system within 24 hours of completion
• Experience with electronic medical health records
• Home Health Experience
• 
  

Nice to haves:

1. Discharge Planning
2. Working with TruCare which is the software the team uses
3. 
   

Disqualifiers:

• Not having field experience
• Not having previous experience with high caseloads
• 
  

Performance indicators: Bilingual always preferred - req will indicate if Bilingual is required via the notes section

• Top 3 must-have hard skills
• Level of experience with each
• Stack-ranked by importance
• Candidate Review & Selection
• 
  

1
2 years of field case management

2
Technology Savy

3
Must be able to look at calendar and manage time - ensuring enough time for documentation

Position is offered by a no fee agency.