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Position Title: LTSS Service Care Manager
Work Location: Cumberland County, NC (up to 2.5-hour one-way radius from home residence for face-to-face member visits; mileage and lodging reimbursed if needed)
Assignment Duration: 6 months (possibility to extend or convert)
Work Schedule: ongoing work schedule 8-5 Mon-Fri EST
Training Schedule: Training 8-5 Mon-Fri EST (3.5 weeks, cameras on, no time off);
Work Arrangement: Hybrid - Remote 1-2 admin days per week; in-person member visits 3-4 days per week in the field (up to 1-4 visits per day; longer drive times may mean only 1 visit/day).
Quarterly team meetings/training at Raleigh or Charlotte office locations. 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. Member facing but potentially provider facing. 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.
* 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
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1 |
Physical hospital Health, Care Management, Utilization Mgt, Home Health - all and/or background |
| 2 |
Microsoft office - Tech savvy |
| 3 |
Bedside care management |
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