LTSS Service Care Manager – J01031 Position Available In [Unknown county], Florida

LTSS Service Care Manager

• J01031#25-62899
  Various, FL
  All On-site Job Description
  Job Profile Summary

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
For Arkansas Total Care plan

• This position is designated as safety sensitive in Arkansas and requires a driver’s license, child and adult maltreatment check (before hire and recurring), and a drug screen (at time of hire and recurring).

Must reside in AR or border city.

Travel:

5%. required 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
Comments for

Vendors:

candidates are lacking in answering questions from the team during the interview
Even though the team is seeking bi-lingual candidaites

• they are noticing that if English is not their first language, they may not be understanding the ask / question
  Team needs to ensure the CW is able to provide adequate and sufficent feedback
  Assessments to members will be completed in English
• but with that they are looking to ensure comprehension
  Also looking for candidates within the northern Miami (Hialeah) 33012, 33013, 33147 (Miami) 33130, N, Miami 33180

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?

Team has anywhere from home and community caseload (home and community based & nursing home)
Home 60 members
Mixed would be 60-70 members
The numbers may fluctuate based on business needs
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 Remote Training
• 30 days
  Involves field-based training where the case managers will get to shadow on their last week (week 5)
• hands on experience
  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 care plans.
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 members 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
Each member must be contacted once per month, and some may need to be seen Candidate Requirements
Education/Certification

Required:

Requires a Bachelor’s degree and 2

• 4 years of related experience

Preferred:

n/a
Licensure

Required:

n/a

Preferred:

n/a Years of experience required
Disqualifiers
Best vs. average
Performance indicators Must have:
Case management (2 years)
Strong Microsoft skills Nice to have
Bi-lingual or Tri-lingual would be great but must be able to communicate (verbal and written) in English as well. The members will have intakes in English, but should there be any language barriers that is why the team is seeking someone Bi-Lingual. Previous interview feedback from HM on a general level:
candidates are lacking in answering questions from the team during the interview
Even though the team is seeking bi-lingual candidates

• they are noticing that if English is not their first language, they may not be understanding the ask / question
  The team needs to ensure the CW can provide adequate and sufficient feedback
  Assessments to members will be completed in English
• but with that they are looking to ensure comprehension Best vs.

average:

Someone with great time management and great communication and written skills to the hiring manager it is very important for this person to be a team player Someone who is adaptable to change Training is completed virtually and not everyone is a virtual learner

• this person should know and be comfortable with that Top 3 must-have hard skills
  Level of experience with each
  Stack-ranked by importance
  Candidate Review & Selection 1 targeted case management is a good background to have
  2 Case management is a great background to have
  3 Strong Microsoft skills
  Candidate Review & Selection Shortlisting process
  Second touchpoint for feedback
  Interview Information

Onboard Process and Expectations Projected HM Candidate Review Date:

24-48 hours post shortlisting

Number and Type of Interviews:

TEAMS
Extra Interview Prep for

Candidate:

n/a
Required Testing or Assessment (by Vendor): WPM to be included on resume (40 WPM minimum)