Case Manager Long-term Care - New Castle County, Delaware

Highmark Health; Delaware; Remote; USD 57,000 - 108,000; Full time

Job summary

A leading health provider is seeking a Case Manager for Long-term Care in Delaware. This role involves coordinating care for members, conducting assessments, and ensuring compliance with health standards. Successful candidates will have a relevant degree and experience in case management, primarily working from home with occasional travel.

Qualifications

• Bachelor's or Master's in Social Work required with experience.
• RN or LPN with relevant case management experience considered.
• 3 years’ experience with elderly or disabled populations if only a high school diploma.

Responsibilities

• Conduct face-to-face needs assessments and follow-up calls.
• Coordinate care supporting physical, behavioral, and social needs.
• Develop and revise care plans with members or caregivers.

Skills

Cultural competency

Cost management

Flexible working hours

Reliable transportation

MS Office proficiency

Electronic documentation systems

Education

Bachelor's degree in Social Work or related field

Master’s degree in Social Work or related field

Registered Nurse or Licensed Practical Nurse

High school diploma

Job description

Thank you for your interest in employment at a Highmark Health company. Highmark Health uses an online application process. If you participate through this Workday site, your personal information will be collected, including resume, education, contact details, IP address, and other data you provide. We will inform you how this data is used and processed, and seek your consent according to the Highmark Health Data Protection Statement and GDPR.

Case Manager Long-term Care - New Castle County, Delaware

Apply now for a remote, full-time position based in New Castle County, DE. Posted 2 days ago. Job requisition ID: J264639.

Company :

Highmark Inc.

Job Description :

JOB SUMMARY

This role serves as the main contact for members, coordinating their care needs across various service systems and community supports. It is a community-based position requiring frequent travel within Delaware to members’ homes, nursing facilities, and community settings for those enrolled in DSHP Plus LTSS.

ESSENTIAL RESPONSIBILITIES

1. Travel to members’ homes, facilities, and community settings to conduct face-to-face needs assessments and follow-up calls, adhering to guidelines and policies.
2. Assess, plan, coordinate, implement, and evaluate care for members with complex health and social needs in various settings.
3. Coordinate care across services, supporting physical, behavioral, and social needs in a safe, cost-effective manner.
4. Facilitate authorization, continuity, and appropriateness of care and services in community or HCBS.
5. Manage transitions between care settings, such as hospital to home or nursing facility to community.
6. Educate members and caregivers about health needs, benefits, and available services.
7. Develop and revise care plans with members or caregivers to meet their specific needs and goals.
8. Identify resources and facilitate referrals to specialized programs like disease management or behavioral health.
9. Collaborate with healthcare teams to coordinate care and community resources.
10. Assist in developing backup plans for provider coverage gaps.
11. Ensure services are delivered as outlined in care plans.
12. Evaluate and revise care plans as needed, ensuring compliance with policies and contractual requirements.
13. Document all services and interventions in the electronic health record.
14. Maintain compliance with privacy laws (HIPAA) and quality standards.
15. Perform other duties as assigned.

QUALIFICATIONS

Required

• Bachelor's degree in Social Work or related field + 3 years’ experience OR
• Master’s degree in Social Work or related field + 1 year’ experience OR
• Registered Nurse or Licensed Practical Nurse + 2 years’ experience OR
• High school diploma + 3 years’ case management experience with elderly or disabled populations.

Preferred

• Experience in home clinical or case management
• Certifications like CCM, LBSW, LMSW, LCSW
• Experience with HIV/AIDS, behavioral health, developmental disabilities, Medicare/Medicaid, or managed care

Skills

• Flexible working hours and reliable transportation
• Proficiency in MS Office and electronic documentation systems
• Understanding of cultural competency and cost management

Additional Information

Travel requirement: 25-50%. Work from home with occasional site visits. Physical demands include lifting up to 25 pounds. Complies with all privacy, security, and behavioral standards. Salary range: $57,700 - $107,800. For accommodations, contact [e-mail].

This position is active and accepting applications.