LTSS Service Care Manager

Position Title: LTSS Service Care Manager

Work Location: Candidates must reside in West Palm Beach County - Boca Raton area. Zip Codes: 33428 33433 33434 33496 33498 33427 33429 33431 33432 33481 33486 33487 33488 33497 33499

Assignment Duration: 12 months

Work Schedule: Monday - Friday 8 am - 5 pm

Work Arrangement: This is a remote position working from a home office. The role is remote but also requires field work - while allows for a self-made independent role. Southern Palm Beach County is the target location.

Position Summary: Assists in developing, assessing, and coordinating holistic care management activities to enable quality, cost-effective healthcare outcomes. May develop or assist with developing personalized service care plans/service plans for long-term care members and educates members and their families/caregivers on services and benefits available to meet member needs.

Background & Context:

• Stabilizing Long term care workforce, supporting and maintaining compliance as we continue into our new contract requirements effective 2/1/25. We were awarded the entire state for the new state contract.
• Opportunity for promoting and growth from within the company. Promotional opportunity who wants to grow within the company and continue to develop even across to other lines of business
• We have a diverse team as our membership is diverse. Having a diverse workforce only helps the plan to better serve our members. The interview panel will consist of a diverse panel.
• Prefer Spanish Speaking
• The position will be 8 to 5 with the possibility of participating in a flex work week after bring hired on FTI ( to be reviewed/approved by leadership based on performance in the role)
• The team has a strong longevity and many of the team have been a part of the team for years
• They can build and schedule their meetings throughout the week
• Interacting with members, family members, providers and other departments to ensure member's needs are being met. member/provider requests/issues/concerns
• Visit members in field and return to home office to complete documentation .
• managing difficult members, multiple priorities. Positive attitude, problem solver/solutions oriented, empathy while ensuring business needs are met.
  
  Key Responsibilities:
• Evaluates the needs of the member, the resources available, and recommends and/or facilitates the plan for the best outcome
• Assists with developing ongoing long-term care plans/service plans and works to identify providers, specialist, and/or community resources needed for long-term care
• Coordinates as appropriate between the member and/or family/caregivers and the care provider team to ensure identified services are accessible to members
• Provides resource support to members and their families/caregivers for various needs (e.g. employment, housing, participant direction, independent living, justice, foster care) based on service assessment and plans
• Monitors care plans/service plans, member status and outcomes, as appropriate, and provides recommendations to care plan/service plan based on identified member needs
• Interacts with long-term care healthcare providers and partners as appropriate to ensure member needs are met
• Collects, documents, and maintains long-term care member information and care management activities to ensure compliance with current state, federal, and third-party payer regulators
• May perform home and/or other site visits to assess member's needs and collaborate with healthcare providers and partners
• Provides and/or facilitates education to long-term care members and their families/caregivers on procedures, healthcare provider instructions, service options, referrals, and healthcare benefits
• Provides feedback to leadership on opportunities to improve and enhance quality of care and service delivery for long-term care members in a cost-effective manner
• Performs other duties as assigned
• Complies with all policies and standards
  
  Qualification & Experience:
• Requires a Bachelor's degree and 2 - 4 years of related experience.
• Or equivalent experience acquired through accomplishments of applicable knowledge, duties, scope and skill reflective of the level of this position.
  
  License/Certification:
• RN or LCSW / LCSW-A preferred
• Required: Requires a Bachelor's degree and 2 - 4 years of related experience
• Preferred: n/a
• Required: Drivers License
• Preferred: n/a
• experience with field based case management, remote work, Average CL #, home visits, care plan development, experience with type of assessments.
• ? 2+ years of Care Management experience (field experience is a must)
• ? Caseloads of 50,60,70 members - bonus if it is geriatric
• ? Long Term Care Medicaid experience
• ? Medicaid / Medicare experience
• ? Need to see experience being able to manage high case load
• ? Fast paced environment regarding new processes and programs
• ? They must be comfortable being able to connect with IT should their equipment fail in the field, etc. or be able to go into an office location or IT space.
• ? All documentation must be within system within 24 hours of completion
• ? Experience with electronic medical health records
• ? Home Health Experience
• Prefer experience working with TruCare which is the software the team uses
• Experience in Case Management in senior services, state agencies. Team Player, problem solver, solutions oriented, member centric, Integrity
• 1 Field based case management
• 2 Remote work
• 3 Experience working with geriatric population