LTSS Service Care Manager

Position Title: LTSS Service Care Manager
Work Location: Delaware - New Castle County
Assignment Duration: 6 months (Possible extension OR conversion)
Work Schedule: 8am - 5pm EST Mon - Fri (No OT expectations)
Work Arrangement: Field-based / Member-facing (home and site visits required)

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.

• Position will be completing LTSS level of care redetermination and will be completing a mixture of care visits and supporting other LTSS case managers.
• Support the case management team due to high increase in membership.
• Level of care redeterminations, transition of care and Case management

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

Candidate Requirements Education/Certification Required: Bachelor's degree and 2 - 4 years of related experience. Preferred: Licensure Required: Delaware/Compact RN License, Driver's license Preferred:

• Years of experience required
• Disqualifiers
• Best vs. average
• Performance indicators

Must haves: Driver's license, Home workspace | Level of Care Redetermination, Transition of Care and Case Management experience

Nice to haves: Service Care Manager

Disqualifiers: Location should be within Delaware

Performance indicators: 4-5 assessments per week, for redeterminations 4-5 daily

• Top 3 must-have hard skills
• Level of experience with each
• Stack-ranked by importance
• Candidate Review & Selection

1 Computer literate 2 Experience on evaluating older adults/disabled level of functioning 3 Experience with medication reconciliation