Job Profile Summary
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.Education/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 Iowa Only: Bachelor's degree with 30 semester hours or equivalent quarter hours in a human services field (including, but not limited to, psychology, social work, mental health counseling, marriage and family therapy, nursing, education, occupational therapy, and recreational therapy) and at least two years of experience in the delivery of services to the population groups or current state's Registered Nurse (RN) license and at least four years of experience required
For North Carolina Standard 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 required.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 preferred
For Arkansas Total Care plan - This position is designated as safety sensitive in Arkansas and requires a driver's license, child and adult maltreatment check (before hire and recurring), and a drug screen (at time of hire and recurring). Must reside in AR or border city. Travel: 5%. requiredResponsibilities
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 members 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 manner
Performs other duties as assignedComplies with all policies and standardsComments
Hiring for Crystal City, Texas

LTSS Service Care Manager - J01031

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