Residential Services Specialist (Org Wide)

About the role

Join our award-winning culture as we serve members in your area! Under the direction of the Behavioral Health and Utilization Manager, the Residential Services Specialist will actively support Care Management’s understanding and utilization of the least restrictive and most integrated residential settings available to members when it is determined that a member requires residential care to best support outcomes.

Responsibilities

• Serve as a resource and collaborate through consultation with LCI’s Care Management staff to support comprehensive, outcome-based care planning for members with complex care planning needs.
• Review the member record and evaluate the impact of this information on the assessment and care planning process specific to the member’s potential need for residential services.
• Collect, analyze, and utilize data to support informed decision making for member care and provider needs to promote holistic care planning.
• Develop and analyze proactive indicators to address changing and emerging needs of members.
• Identify barriers to placement and address problems cooperatively as they occur.
• Partner and collaborate with IDT Staff to understand and meet members’ community-based residential needs.
• Develop and provide training on new and/or more effective guidance to improve overall experiences with residential placement processes for LCI members, providers, and IDT staff.
• Collaborate with internal stakeholders, including CM Practice, Utilization, Behavioral Health, Provider Relations, and Business/Fiscal, to ensure quality and sustainability outcomes are met.
• Work in partnership with other internal divisions to monitor, evaluate and process residential service rate negotiations for member changes in condition and exceptional care needs.
• Liaison with community and provider stakeholders as needed to develop and strengthen our service delivery outcomes and sustainability.

Requirements

• Bachelor’s degree in a Health or Human Services related field, or equivalent combination of education and experience.
• Minimum of two (2) year’s professional experience in a long-term care organization or community-based setting required.
• Demonstrates proficiency in applying the Family Care principles and Resource Allocation Decision process to practice.
• Strong data analysis and application skills.
• Strong evaluation, assessment, and interview skills.
• Must demonstrate proficiency in Microsoft Office (Word, Excel, PowerPoint, Outlook).
• Must have exceptional verbal and written communication skills.
• Must have creative problem solving and critical thinking skills.
• Must have excellent organization and interpersonal skills.
• Must have strong analytical and negotiation skills.
• Ability to develop effective working relationships with providers, external stakeholders, and care management staff.
• Current driver’s license, acceptable driving record and proof of adequate insurance required.

About our organization

Lakeland Care is a Wisconsin-based non-profit organization that focuses on creating a world we all want to live in. With long-standing roots as a managed care organization (MCO), we provide long-term care services to eligible elders and individuals with physical and intellectual or developmental disabilities.

Our Mission: Empowering individuals. Strengthening communities. Inspiring futures. Our Vision: To create a world we all want to live in. Our Core Values: Kindness, Inclusion, Trust.