Clinical – LTSS Service Care Manager LTSS Service Care Manager Position Available In [Unknown county], Florida

Clinical•LTSS Service Care Manager LTSS Service Care Manager#25-57095
Various, FL
All On-site Job Description

Job Description:

“

Position Purpose:

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.

Education/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. “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”

License/Certification:

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 two years of experience required”
Comments for

Vendors:

All candidates must reside in region 8•Spanish speaking preferred•Must reside within Ft.

Myers EEO:

“Mindlance is an Equal Opportunity Employer and does not discriminate in employment on the basis of•Minority/Gender/Disability/Religion/LGBTQI/Age/Veterans.” ======
Centene Job Description
“

Position Purpose:

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.

Education/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.

License/Certification:

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” “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” Story Behind the Need•Business Group & Key Projects Health plan or business unit
Team culture
Surrounding team & key projects
Purpose of this team
Reason for the request
Motivators for this need
Any additional upcoming hiring needs? Sunshine State Health Plan
The team has a strong longevity and many of the team have been a part of the team for years
This role is remote but also requires field work•while allows for a self-made independent role.
They can build and schedule their meetings throughout the week Typical Day in the Role Daily schedule & OT expectations
Typical task breakdown and rhythm
Interaction level with team
Work environment description 8-5 Mon-Fri; Monthly and quarterly member contact and will include 80% travel. Remote role. Will require a driver’s license.
Managing a case load for healthcare members with long term care needs.
Geriatric long term care
Member assessments and notes.
Complete assessments with members, caregivers, or providers to obtain information regarding client status, support system, and need for services for care plan development.
Monitor delivery of services and follow-up with members, caregivers, or provider s through in person visits and telephonic contact
Authorize and coordinate referral 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 to integrate into the member care plan 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. Compelling Story & Candidate Value Proposition What makes this role interesting?
Points about team culture
Competitive market comparison
Unique selling points
Value added or experience gained Working with members in a face-to-face environment
This position does have the intent to convert based on performance and eligibility
Independent work Candidate Requirements
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