Clinical Case Manager DE Long Term Services & Support RN | LCSW

Responsibilities

• Assists members in obtaining LTSS services as required by DSHP Plus LTSS.
• Contributes to the LTSS case management process by performing assessments and managing member needs.
• Completes Level of Care Redeterminations annually or more frequently as needed.
• Provides clinical support to non-licensed case managers and acts as a secondary case manager during acute episodes.
• Conducts reevaluations of level of care annually or more frequently as needed.
• Supports non-licensed case managers with clinical reviews and condition-specific assessments.
• Develops care plans and initiates services for new members.
• Facilitates person-centered planning team meetings to coordinate care and services.
• Identifies, coordinates, and assists participants in accessing needed LTSS and other services.
• Provides information to participants and monitors authorized services.
• Informs participants about their rights, responsibilities, and assists with complaints and hearings.
• Collects necessary information and develops the Plan of Care.
• Monitors worklists in Jiva, including new members and urgent services.
• Makes recommendations and takes actions related to critical incidents.
• Liaises with Physical Health Care Coordination program and LTSS/DSPN members.
• Completes comprehensive assessments, care plans, medication reconciliations, and discharge planning.

Requirements

• Delaware licensed RN or LCSW required.
• Valid driver’s license required.
• Knowledge of home and community-based service system and ability to access and arrange services.
• Ability to provide informed advocacy and interact professionally with members and health care professionals.
• Ability to travel up to 75%.

Qualifications

• Experience in case management and home health care.
• Strong communication and interpersonal skills.
• Proficiency in Microsoft Office.

Skills

• Excellent communication and problem-solving skills.
• Ability to manage multiple tasks and prioritize effectively.
• Strong organizational and analytical skills.

Benefits

Discover more about our comprehensive benefits package, which includes flexible work solutions, competitive pay, paid time off, health insurance coverage, and more.