Care Manager, LTSS

We need to output HTML fragment with headings

for sections: About the role, Responsibilities, Requirements, Qualifications, Skills, Benefits, Pay, Schedule. Only include sections if posting has real specific content. We need to parse the posting. Given text: Employment Type Full-time Exempt or Non-Exempt Exempt Job Summary Hybrid Work Environment - Must reside on Maui or Hawaii Island ** Pay Range: $68,000 - $133,000 Note: Individuals typically begin between the minimum to middle of the pay range The Care Manager is an experienced licensed healthcare professional who is uniquely qualified to provide care management for members. The position collaborates with a multidisciplinary team--including physicians, nurses, social workers, and/or other care professionals--. The position partners with healthcare providers, members, and authorized representatives to oversee care delivery and advocate for improved health equity, access, and outcomes. The position is accountable for achieving organizational goals and key performance indicators (KPIs), with a focus on enhancing member experience, reducing morbidity, mortality, and hospital utilization, and minimizing overall healthcare costs. Provides care management for members needing long-term services and supports (LTSS) to include home and community-based services (HCBS), residential settings, and nursing facilities.Authorizes appropriate home-based community services.Addresses care gaps and reduces risk of inpatient admissions and emergency department utilization.Conducts evaluations (i.e., DHS 1147) for nursing facility level of care services.Facilitate effective communication and collaboration with interdisciplinary healthcare teams including care pod members with Community Health Workers (CHWs). Minimum Qualifications Three years of relevant healthcare or clinical experience; or equivalent combination of education and experience. Demonstrates thorough expertise in care transitions with little supervision required. Possesses strong documentation and research abilities, can analyze information, make decisions, and communicate effectively both verbally and in writing. Displays interpersonal skills, resolves conflicts, and acts with integrity. Highly organized, able to multitask independently, fostering adaptability and teamwork. Performs well in a fast-paced setting and readily adapts to changes. Delivers outstanding customer service to both internal and external clients. Utilizes excellent analytical and critical thinking to evaluate medical necessity and the suitability of patient services and treatment individually. Safeguards patient privacy in accordance with Federal (HIPAA), organizational, and departmental regulations. Clearly communicates with providers and health care teams while building collaborative relationships. Intermediate working knowledge in Microsoft Office applications, including but not limited to Word, Outlook, and PowerPoint. Experience with electronic medical records such as EPIC and HHIE. Healthcare Professional license in the State of Hawaii**(upon hire, proof of licensure to be provided by employee to Human Resources as well as a signed "Clinical Affirmation Statement for RN/LSW" form if applicable) Reliable transportation to perform in person (Face to Face) meetings or in alternative settings. Duties And Responsibilities Assessment & Planning Conducts comprehensive assessments--including physical, psychosocial, and health literacy evaluations--and interprets relevant diagnostic data to identify member and family needs. Applies critical thinking skills to analyze complex cases and determine underlying causes contributing to high costs. Uses these insights to inform individualized transition/treatment plans and address gaps in care delivery. Partners with and empowers the member to develop an actionable care plan that helps prevent avoidable utilization. Collaboration & Education Assesses educational needs of members and families, ensuring clear and sufficient information is provided. Facilitate effective communication and collaboration with interdisciplinary healthcare teams, including the member, their support person(s), other family members and external stakeholders to develop, implement, and evaluate individualized care plans, and to address systemic challenges in member care. Care Coordination and Delivery Coordinates a multi-disciplinary team to include but not limited to member's PCP, specialists, the member, caregivers, and other members of the healthcare team to ensure timely access to appropriate medical care, behavioral health care, and services Coordinates and monitors activities among internal departments, external community agencies. Quality Improvement & Leadership Engages in quality improvement initiatives, supports leadership in system-level improvements, analyzes data for program enhancement, and mentors' colleagues to promote best practices. Advocacy & Documentation Advocates for members and families across the healthcare continuum and ensures thorough documentation of all care activities. Performs all other miscellaneous responsibilities and duties as assigned or directed We need to remove boilerplate: Employment Type, Exempt, etc? The instruction: Remove cookie/navigation/legal/EEO/equal-opportunity/scam-warning boilerplate, duplicated lines, and application instructions. Employment type maybe not boilerplate but could be considered metadata; they said "do NOT put Job ID / requisition numbers as headings — fold minor metadata into a short

or drop it." So we can include employment type etc as a short paragraph maybe under About the role? Or we could drop it. The instruction: "Prefer a few substantive sections over many thin ones." So we can combine some. We need sections: About the role (maybe job summary), Responsibilities, Requirements, Qualifications, Skills, Benefits, Pay, Schedule. We have Pay Range: $68,000 - $133,000 and note about typical start. So we can include Pay section. We have Hybrid Work Environment - Must reside on Maui or Hawaii Island. That's about location/work arrangement; could be in About the role or maybe Schedule? Not schedule. Could be in About the role. We have no explicit Benefits section. So we should not create Benefits unless posting states them. It doesn't. So omit Benefits. Schedule: Not mentioned. So omit Schedule. Skills: Could be derived from Minimum Qualifications etc. But we have Qualifications and Skills separate. The posting includes Minimum Qualifications (which could be Qualifications). Also includes many skill-like items (documentation, research, communication, interpersonal, etc). We could put those under Skills. Or we could combine Qualifications and Skills. But we need to follow instruction: include a section ONLY when posting has real, specific content for it. So we need to decide what content maps to each heading. We have: - About the role: could be the Job Summary paragraph(s) describing role, hybrid work environment, etc. - Responsibilities: Duties And Responsibilities section with bullet points. - Requirements: maybe Minimum Qualifications? Or Requirements could be the same as Minimum Qualifications. But we also have Qualifications heading. Might be redundant. Perhaps we treat Minimum Qualifications as Requirements, and then Qualifications could be something else like license, etc. But the posting includes "Healthcare Professional license in the State of Hawaii" under Minimum Qualifications list. So maybe we split: Requirements = experience, education; Qualifications = license, transportation, etc. However the instruction says prefer few substantive sections over many thin ones. So maybe we combine Requirements and Qualifications into one section called Qualifications (or Requirements). But we have both headings allowed; we need to decide. We could make: - About the role (summary) - Responsibilities (duties) - Qualifications (includes minimum qualifications, license, transportation, etc.) - Skills (maybe derived from abilities like documentation, communication, analytical, etc.) But those are already in qualifications. Better to have: - About the role - Responsibilities - Qualifications (covers experience, education, license, transportation, etc.) - Skills (covers specific abilities: documentation, research, communication, interpersonal, analytical, critical thinking, etc.) - Pay We need to ensure we don't create sections with filler. All content must be preserved. Let's extract content for each. About the role: Should include the Job Summary paragraph(s) and hybrid work environment note. Job Summary: "Hybrid Work Environment - Must reside on Maui or Hawaii Island". Then the paragraph: "The Care Manager is an experienced licensed healthcare professional who is uniquely qualified to provide care management for members. The position collaborates with a multidisciplinary team--including physicians, nurses, social workers, and/or other care professionals--. The position partners with healthcare providers, members, and authorized representatives to oversee care delivery and advocate for improved health equity, access, and outcomes. The position is accountable for achieving organizational goals and key performance indicators (KPIs), with a focus on enhancing member experience, reducing morbidity, mortality, and hospital utilization, and minimizing overall healthcare costs. Provides care management for members needing long-term services and supports (LTSS) to include home and community-based services (HCBS), residential settings, and nursing facilities.Authorizes appropriate home-based community services.Addresses care gaps and reduces risk of inpatient admissions and emergency department utilization.Conducts evaluations (i.e., DHS 1147) for nursing facility level of care services.Facilitate effective communication and collaboration with interdisciplinary healthcare teams including care pod members with Community Health Workers (CHWs)." We'll combine that into About the role. Responsibilities: The Duties And Responsibilities section with subheadings Assessment & Planning, Collaboration & Education, Care Coordination and Delivery, Quality Improvement & Leadership, Advocacy & Documentation. We need to output as

• for any list of duties/requirements/benefits. So we need to turn each duty into list items. Could keep subheadings as maybe

  ? But instruction only says use

  for section headings. It didn't forbid other headings, but we should stick to

  for sections. For subheadings inside responsibilities we could just include them as part of list item text or as . Safer to just list each duty as list items, preserving the content. Thus we will create a

  with each duty sentence as
  • . We'll need to split the responsibilities into distinct items. Let's list them: Assessment & Planning: - Conducts comprehensive assessments--including physical, psychosocial, and health literacy evaluations--and interprets relevant diagnostic data to identify member and family needs. - Applies critical thinking skills to analyze complex cases and determine underlying causes contributing to high costs. Uses these insights to inform individualized transition/treatment plans and address gaps in care delivery. - Partners with and empowers the member to develop an actionable care plan that helps prevent avoidable utilization. Collaboration & Education: - Assesses educational needs of members and families, ensuring clear and sufficient information is provided. - Facilitate effective communication and collaboration with interdisciplinary healthcare teams, including the member, their support person(s), other family members and external stakeholders to develop, implement, and evaluate individualized care plans, and to address systemic challenges in member care. Care Coordination and Delivery: - Coordinates a multi-disciplinary team to include but not limited to member's PCP, specialists, the member, caregivers, and other members of the healthcare team to ensure timely access to appropriate medical care, behavioral health care, and services - Coordinates and monitors activities among internal departments, external community agencies. Quality Improvement & Leadership: - Engages in quality improvement initiatives, supports leadership in system-level improvements, analyzes data for program enhancement, and mentors' colleagues to promote best practices. Advocacy & Documentation: - Advocates for members and families across the healthcare continuum and ensures thorough documentation of all care activities. - Performs all other miscellaneous responsibilities and duties as assigned or directed We'll keep these as list items. Qualifications: Minimum Qualifications list (including experience, expertise, documentation, interpersonal, organized, fast-paced, customer service, analytical, privacy, communication, Microsoft Office, EMR experience, license, transportation). We'll list each as
  • . Skills: Could be derived from abilities like documentation, research, communication, interpersonal, analytical, critical thinking, etc. But many overlap with qualifications. To avoid duplication, maybe we don't need Skills section; we can incorporate those into Qualifications. However the instruction says we can include Skills if posting has real specific content. The posting does mention specific skills: "strong documentation and research abilities", "interpersonal skills", "excellent analytical and critical thinking", "utilizes excellent analytical and critical thinking", "clear communication", etc. So we could create Skills section listing those. But to avoid duplication, we could treat Qualifications as the minimum qualifications (experience, education, license, transportation) and Skills as the abilities. Let's split: Qualifications (minimum): - Three years of relevant healthcare or clinical experience; or equivalent combination of education and experience. -