LTSS Service Care Manager
4 Days Old
Position Title: LTSS Service Care Manager
Work Location: Hamilton County, Florida
Assignment Duration: 12 Months (possibility to extend or convert)
Work Schedule: 8-5 Mon-Fri
Work Arrangement: 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 :
Supports our organization's Sunshine State Health Plan in delivering long-term care services to members. Doesn't need to be Spanish speaking.
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.
Education/Certification
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
Licensure
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:
Discharge Planning
Working with TruCare which is the software the team uses
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
Position is offered by a no fee agency.
- Location:
- Jacksonville
- Category:
- Healthcare Practitioners And Technical Occupations