LTSS Service Care Manager

Position Title: LTSS Service Care Manager

Work Location: North Carolina (Guilford County & Pitt County areas)

Assignment Duration: 06 months (Possibility to extend or convert)

Work Arrangement: Field-Based Hybrid (Remote admin + Field visits)

Position Summary:
Assists in developing, assessing, and coordinating holistic care management activities to enable quality, cost-effective healthcare outcomes.
Will 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:
Additional staff needed due to business fluctuation

Key Responsibilities:

• Managing a case load for healthcare members with LTSS (Long Term Support/Services) needs.
• Monthly and quarterly member contact and will include 80% travel. Remote role. Will require a driver's license.
• Member assessments and notes.
• Complete assessments with members, caregivers, or providers to obtain information regarding client status, support system, and need for services 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 referral for services.
• Ensure provider services are delivered without gaps and identify functional deficiencies in plans of care.
• 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 plan, care plan, and coordination of acute care and long-term care services
• Assist member with filing and resolving complaints and appeals Education/Certification Required: Bachelor's Preferred: Licensure Required: RN and/or LCSW/LCSW-A/BSN/ADN Preferred: Years of experience required: 2-4+ years of physical health care management experience, 4-6+ years of physical health care management experience preferred. Hospital CM, Home health, discharge planning, or long-term care experience preferred. Case management and care planning experience.
  
  Preferred - Home health experience, community health/member facing, discharge planning
  
  Disqualifiers: No Psych experience such as counseling (must have bedside case management hospital physical as well) no Right out of nursing school. No Nursing homes. No rehab.
  
  Additional qualities to look for: Virtual, All Microsoft office, Experience with electronic medical health records
  • Top 3 must-have hard skills stack-ranked by importance
  1 Physical hospital Health, Care Management, Utilization Mgt, Home Health - all and/or background 2 Microsoft office - Tech savvy 3 Bedside care management