LTSS Service Care Manager

About the role

Work Mode: Remote with in-person visits required, 3-4 days a week in the field. Location: Guilford County, NC; Pitt County, NC; Cumberland County, NC. Duration: 6 months, possible extension or conversion to permanent. Shift: Training 8-5 Mon-Fri EST, work schedule 8-5 Mon-Fri EST.

Responsibilities

• Manage a case load for healthcare members with LTSS (Long Term Support/Services) needs
• Conduct monthly and quarterly member contact, involving 80% travel
• Complete assessments with members, caregivers, or providers to gather information for care plan development
• Monitor delivery of services and follow-up with members, caregivers, or providers through in-person visits and telephonic contact
• Authorize and coordinate referrals for services
• Ensure provider services are delivered without gaps and identify 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 and care plans
• Assist members with filing and resolving complaints and appeals

Requirements

• Bachelor's degree required
• Licensed Clinical Social Worker/Registered Nurse License required
• Minimum 2 years of physical health care management experience
• Valid driver's license required
• Experience with Microsoft Office and electronic medical health records

Preferred Skills

• 4+ years of physical health care management experience preferred
• Experience in hospital CM, home health, discharge planning, or long-term care preferred
• Case management and care planning experience
• Home health experience, community health/member facing, discharge planning