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

Responsibilities

• Assists members who are eligible for LTSS in obtaining the services they need as required by DSHP Plus LTSS in New Castle county as well as Milford, DE to include lower Kent and northern Sussex counties.
• Contributes to the LTSS case management process by performing telephonic and/or face-to-face assessments for the identification, evaluation, coordination and management of member’s needs, including physical health, behavioral health, social services and long term services and supports.
• Completes Level of Care Redeterminations for home and community based members annually.
• Provides clinical support to non-licensed case managers as needed.
• Facilitates person-centered planning team meetings to coordinate care and services.
• Identifies, coordinates, and assists participants in gaining access to needed LTSS and other Covered Services, as well as non-covered medical, social, housing, educational, and other services and supports.
• Provides information to participants and conducts monitoring of authorized services and supports for Participants.
• Informs participants about available LTSS required needs assessments, the care plan process, service alternatives and service delivery options.
• Informs participants of their rights and responsibilities as well as assists with the complaint, grievance, and DHS Fair Hearing process.
• Collects additional necessary information, including participant preferences, strengths, and goals to inform the development of the Plan of Care.
• Conducts comprehensive needs assessments annually or more frequently as needed in accordance with requirements.
• Reviews and acts upon worklists in Jiva, including monitoring of new members.
• Authorizes urgent services when needed.
• Makes recommendations and takes actions as required with other corporate entities.
• Liaises with Physical Health Care Coordination program.
• Works with LTSS and DSNP members to complete comprehensive assessments, care plans, medication reconciliation, monitoring follow-up and progress, and assists with discharge planning/transitions of care.

Requirements

• Delaware licensed RN or LCSW required.
• Valid driver’s license required.

Qualifications

• Knowledge of the home and community-based service system and how to access and arrange for services.
• Ability to provide informed advocacy.
• Ability to interact with members face to face.
• Ability to interact with health care professionals in a professional manner.
• Ability to travel up to 75%.

Skills

• Strong communication skills.
• Ability to manage multiple tasks and prioritize effectively.
• Proficiency in Microsoft Office Suite.

Benefits

Our Comprehensive Benefits Package includes:

• Flexible work solutions including remote options, hybrid work schedules.
• Competitive pay.
• Paid time off including holidays and volunteer events.
• Health insurance coverage for you and your dependents on Day 1.
• 401(k).
• Tuition reimbursement.