You could be the one who changes everything for our 28 million members. Centene is transforming the health of our communities, one person at a time. As a diversified, national organization, you’ll have access to competitive benefits including a fresh perspective on workplace flexibility.Centene is hiring! We are seeking a LTSS Service Care Manager to join our Carolina Complete Health team. The ideal candidate will be a Registered Nurse (RN) or hold a license as a Licensed Clinical Social Worker (LCSW or LCSW-A), with experience in physical health, case management, and/or field-based care. This role requires 80% field work, visiting members in their homes or care facilities to provide hands-on support and coordination.Position Purpose: 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.Evaluates the needs of the member, the resources available, and recommends and/or facilitates the plan for the best outcomeAssists with developing ongoing long-term care plans/service plans and works to identify providers, specialist, and/or community resources needed for long-term careCoordinates as appropriate between the member and/or family/caregivers and the care provider team to ensure identified services are accessible to membersProvides 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 plansMonitors care plans/service plans, member status and outcomes, as appropriate, and provides recommendations to care plan/service plan based on identified member needsInteracts with long-term care healthcare providers and partners as appropriate to ensure member needs are metCollects, documents, and maintains long-term care member information and care management activities to ensure compliance with current state, federal, and third-party payer regulatorsMay perform home and/or other site visits to assess member’s needs and collaborate with healthcare providers and partnersProvides and/or facilitates education to long-term care members and their families/caregivers on procedures, healthcare provider instructions, service options, referrals, and healthcare benefitsProvides feedback to leadership on opportunities to improve and enhance quality of care and service delivery for long-term care members in a cost-effective mannerPerforms other duties as assignedComplies with all policies and standardsEducation/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:For North Carolina Tailored Plan: Two (2) years of prior LTSS and/or HCBS coordination, care delivery monitoring and care management experience; Prior experience with social work, geriatrics, gerontology, pediatrics, or human services.RN or LCSW / LCSW-A preferredPay Range: $26.50 - $47.59 per hourCentene offers a comprehensive benefits package including: competitive pay, health insurance, 401K and stock purchase plans, tuition reimbursement, paid time off plus holidays, and a flexible approach to work with remote, hybrid, field or office work schedules. Actual pay will be adjusted based on an individual's skills, experience, education, and other job-related factors permitted by law. Total compensation may also include additional forms of incentives.Centene is an equal opportunity employer that is committed to diversity, and values the ways in which we are different. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, or other characteristic protected by applicable law.Qualified applicants with arrest or conviction records will be considered in accordance with the LA County Ordinance and the California Fair Chance Act

LTSS Service Care Manager

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