Hybrid Long-Term Care Case Manager

Jefferson County; Pittsburgh (Allegheny County); Hybrid; USD 58,000 - 59,000; Full time

Benefits offered by this job

Medical, dental, and vision insurance

Paid time off and holidays

Retirement matching

Wellness programs

Tuition reimbursement

Flexible schedules

Hybrid work options

Job summary

Jefferson County Human Services is seeking a Long-Term Care Case Manager to oversee client-facing case management for elderly and disabled adults and children with chronic or terminal illness. You will determine eligibility for Medicaid service plans and coordinate care across programs.

Responsibilities include assessments, negotiating rates with providers, attending appeal hearings, and ensuring compliant, cost-effective care plans. Hybrid schedule with a competitive benefits package.

Qualifications

• Bachelor's degree in a related field.
• One year of work-related experience.
• Bilingual in Spanish preferred.
• Ability to learn more than one complex computer system.
• Strong organizational and time management skills.

Responsibilities

• Determine client eligibility by gathering collateral information from hospitals, nursing homes, and home health services.
• Complete a face-to-face assessment of clients.
• Attend court appeal hearings to defend denied applications.
• Prepare all legal documents for the appeal hearing.
• Work with multiple Medicaid programs (HCBS, Elderly, Disabled, etc.).
• Maintain client care plans and reassess for cost-efficient service plans.
• Adhere to state cost containment regulations.
• Inform family members of options available.
• Make referrals as necessary.
• Consult with state agents and negotiate rates with Medicaid providers.

Skills

Bachelor's degree

One year experience

Bilingual in Spanish

Customer service

Organizational skills

Education

Bachelor's degree in a related field

Job description

Jefferson County Human Services is seeking a Long-Term Care Case Manager to oversee client-facing case management for elderly and disabled adults and children with chronic or terminal illness. You will determine eligibility for Medicaid service plans and coordinate care across programs.

Responsibilities include assessments, negotiating rates with providers, attending appeal hearings, and ensuring compliant, cost-effective care plans. Hybrid schedule with a competitive benefits package.