LTSS Service Coordinator - Case Manager (Region D: Highlands/Hardee)

About the role

The LTSS Service Coordinator (Bilingual in Spanish/English) is responsible for conducting service coordination functions for a defined caseload of individuals in specialized programs. In collaboration with the person supported, they facilitate the Person Centered Planning process, document preferences, needs, and self-identified goals, and develop a comprehensive Person Centered Support Plan (PCSP) and backup plan. They coordinate with Medical Directors and interdisciplinary care teams to support development of a fully integrated care plan, engage the member's circle of support, and manage physical health (PH), behavioral health (BH), and LTSS needs.

Responsibilities

• Conduct face-to-face program assessments using various tools with pre-defined questions, applying motivational interviewing techniques for evaluations, and coordinating with clinical healthcare management and interdisciplinary teams.
• Identify members with potential clinical health care needs and coordinate cases, serving as the single point of contact.
• Manage non-clinical needs of members with chronic illnesses, co-morbidities, and/or disabilities, ensuring cost-effective and efficient utilization of long-term services and supports.
• Document short and long-term service and support goals in collaboration with the member’s chosen care team, including caregivers, family, natural supports, service providers, and physicians.
• Identify members that would benefit from alternative levels of service or other waiver programs.
• Serve as a mentor, subject matter expert, or preceptor for new staff, assisting in the formal training of associates, and participating in process improvement initiatives.
• Submit utilization/authorization requests to utilization management with documentation supporting and aligning with the individual’s care plan.
• Report critical incidents to appropriate internal and external parties such as state and county agencies (Adult Protective Services, Law Enforcement).
• Assist and participate in appeal or fair hearings, member grievances, appeals, and state audits.

Requirements

• Requires a BA/BS degree and a minimum of 2 years of experience working with a social work agency; or any combination of education and experience which would provide an equivalent background.
• Specific education, years, and type of experience may be required based upon state law and contract requirements.

Preferred Skills, Capabilities and Experiences

• Bilingual in English/Spanish strongly preferred.
• Licensed Treatment Services (LTSS), case management, social work, or hospital discharge planning experience preferred.