Care Manager, LTC

We're looking for a compassionate and experienced Care Manager to join our Long-Term Care Team! In this role, you'll use your clinical expertise as a licensed RN to assess medical information, review evidence, and make thoughtful benefit eligibility determinations for Long-Term Care (LTC) claims. You'll play a key role in ensuring decisions are accurate, timely, and aligned with policy provisions, while delivering a high-quality customer experience. As a Care Manager, you'll balance claim adjudication responsibilities with opportunities to contribute to strategic initiatives and evolving business priorities. This is an excellent opportunity for a clinically strong, detail-oriented professional who thrives in a collaborative environment and is passionate about supporting customers with care, integrity, and sound judgment. Responsibilities Oversee care management activities, including benefit eligibility reviews, care coordination, and documentation, while ensuring quality, timeliness, and a positive customer experience. Assess clinical needs to determine initial and ongoing eligibility for long-term care benefits. Review clinical evidence, including onsite assessments from vendors, to make accurate benefit eligibility decisions. Monitor claims for high-risk activity and maintain appropriate follow-up schedules based on current protocols. Conduct virtual telehealth assessments when required. Manage multiple priorities and meet deadlines across assigned claims and projects. Collaborate with senior care management staff and cross-functional teams to support accurate decisions and optimal customer service. Stay current with protocols and guidelines through assigned training, regular management check-ins, and team meetings.

Qualifications:

Bachelor's degree in nursing required. Minimum 5 years of nursing experience, with a focus on geriatrics, long-term care, and/or chronic illness management. Prior experience in geriatric nursing and the long-term care industry is strongly preferred. Experience conducting virtual telehealth assessments is considered an asset. Strong ability to work both independently and collaboratively within multidisciplinary teams. Excellent verbal and written communication skills, with the ability to engage effectively with customers and internal partners. Sound clinical judgment and strong decision-making skills to support accurate benefit eligibility determinations. Proficiency in Microsoft Office and comfort learning new systems; current RN compact license in an NLC state is an asset.

When you join our team:

We'll empower you to learn and grow the career you want. We'll recognize and support you in a flexible environment where well-being and inclusion are more than just words. As part of our global team, we'll support you in shaping the future you want to see. The role being advertised is an existing vacancy. Tentang Manulife dan John Hancock Manulife Financial Corporation adalah penyedia layanan keuangan internasional yang membantu memudahkan keputusan dan membuat hidup lebih baik bagi nasabah. Untuk mempelajari lebih lanjut tentang kami, kunjungi https://www.manulife.co.id . Manulife adalah Perusahaan dengan Kesetaraan Kesempatan Kerja Di Manulife/John Hancock, kita merayakan keragaman. Kita berusaha menarik, mengembangkan, dan mempertahankan tenaga kerja yang sama beragamnya dengan nasabah yang kita layani dan untuk mengembangkan lingkungan kerja inklusif yang menerima kekuatan budaya dan individu. Kita berkomitmen untuk melaksanakan rekrutmen, retensi, peningkatan, dan kompensasi secara adil, dan kita mengatur semua praktik dan program tanpa adanya diskriminasi. Baik itu diskriminasi karena ras, keturunan, tempat asal, warna kulit, asal etnis, kewarganegaraan, agama atau keyakinan agama, kepercayaan, jenis kelamin (termasuk kehamilan dan kondisi terkait kehamilan), orientasi seksual, karakteristik genetika, status veteran, identitas gender, ekspresi gender, usia, status pernikahan, status keluarga, disabilitas, maupun alasan lain yang dilindungi oleh hukum yang berlaku. Menyediakan akses hubungan kerja yang adil merupakan prioritas utama kita. Seorang perwakilan Human Resources akan bekerja dengan pelamar yang meminta akomodasi yang wajar selama proses lamaran kerja. Seluruh informasi yang dibagikan selama proses permohonan akomodasi akan disimpan dan digunakan dengan cara yang sesuai dengan hukum dan kebijakan Manulife/John Hancock yang berlaku. Untuk meminta akomodasi yang wajar dalam proses lamaran kerja, silakan hubungi hr@manulife.com . Referenced Salary Location AS,- Massachusetts Jarak Jauh Penuh waktu Working Arrangement Jauh Salary range is expected to be between $61,875.00 USD - $103,125.00 USD Employees also have the opportunity to participate in incentive programs and earn incentive compensation tied to business and individual performance. The actual salary will vary depending on local market conditions, geography and relevant job-related factors such as knowledge, skills, qualifications, experience, and education/training. If you are applying for this role outside of the primary location, please contact hr@manulife.com for the salary range for your location. Manulife/John Hancock offers eligible employees a wide array of customizable benefits, including health, dental, mental health, vision, short- and long-term disability, life and AD&D insurance coverage, adoption/surrogacy and wellness benefits, and employee/family assistance plans. We also offer eligible employees various retirement savings plans (including pension/401(k) savings plans and a global share ownership plan with employer matching contributions) and financial education and counseling resources. Our generous paid time off program in the U.S. includes up to 11 paid holidays, 3 personal days, 150 hours of vacation, and 40 hours of sick time (or more where required by law) each year, and we offer the full range of statutory leaves of absence. We use data and analytics technologies, such as artificial intelligence (AI), and automated processing tools, to analyze and process the information you provide to us or third parties in the application process. For more information, please refer to our personal information collection statement . Know Your Rights I Family & Medical Leave I Employee Polygraph Protection I Right to

Work I E-Verify Company:

John Hancock Life Insurance Company (U.S.A.)