LTSS Service Care Manager

Summary:

• Location: Cumberland County, NC
• Duration: 6 months, possible extension
• Work Mode: Remote with travel
• Shift: Training 8-5 Mon-Fri EST; Work schedule 8-5 Mon-Fri EST

Responsibilities:

• Manage a case load for healthcare members with LTSS (Long Term Support/Services) needs.
• Conduct monthly and quarterly member contact, involving up to 80% travel.
• Complete assessments with members, caregivers, or providers 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 referrals for services.
• Ensure provider services are delivered without gaps and identify functional deficiencies in care plans.
• Collaborate with discharge planners, physicians, and other parties to ensure appropriate discharge plans, care plans, and coordination of acute care and long-term care services.
• Assist members with filing and resolving complaints and appeals.

Requirements:

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

Preferred Skills:

• Experience in hospital CM, home health, discharge planning, or long-term care.
• Proficient in Microsoft Office; tech-savvy.
• Experience with electronic medical health records.
• Home health experience, community health/member facing, discharge planning.