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

Job Posting Closes at 11:59PM on: 10/01/26 Division: Case Management Agency Division Management Level: Individual Contributor Scheduled Weekly Hours: 40 Benefit Eligibility: This position is eligible for Standard Benefits which includes dental, medical, and vision insurance, paid time off and holidays, retirement matching, wellness programs, and tuition reimbursement.

Job Description Summary

Jefferson County Human Services is seeking a Long-Term Care Case Manager responsible for the client-facing work of this division. Depending on the focus of their team, the Long-Term Care Case Manager will provide a variety of case management services to elderly and disabled adults along with children who are experiencing chronic and/or terminal illness. Case managers help determine functional client eligibility for a variety of Medicaid service plans. They also determine appropriate service plans based on the needs of individual clients, negotiate rates with Medicaid providers and other services, and follow up with providers for care and treatment options. Case managers are responsible for assisting clients with denied application options. We are hiring Long Term Care Case managers for the following programs:

• IDD (Intellectual and Developmental Disabilities) Program - The teams in this program are responsible for the long-term case management for clients with Intellectual and Developmental Disabilities and their families.
• Non-IDD Program - The teams in this program are responsible for the long-term case management for clients experiencing needs related to physical disability, chronic illnesses, and aging.
• SGF Intake Program - The teams in this program will be focused on the initial enrollment, documentation of case management and monitoring activities, Most in Need assessment, and other issues related to entering clients in the State benefits program. Aspects of this program will also be focused on training and process improvement for the entire agency.

About Human Services: Through early childhood education, adult and child protection, job training, food assistance, Medicaid, and other programs, Jefferson County Human Services has an additional five internal Divisions that work with hundreds of community partners to help people build better, safer lives. Human Services provides excellent, individualized service throughout the community with their talented, passionate professionals who empower people and communities to thrive. Jeffco offers a work environment that strives to promote the development, strategic vision and scope for work and inclusion practices to strengthen and advance shared departmental goals and alignment with the county strategic plan.

Schedule

Jefferson County operates primarily on a 4 day, 10-hour work week, Monday-Thursday. The Human Services Department works either on a 4 day, 10-hour work week; or on a 5 day, 8-hour work week. This position is hybrid, with remote work and in-office work as determined by team and agency needs.

Compensation

Hiring Range: $58,135.56 - $59,005 annually Compensation will be determined based on education, experience and skills.

Benefits

Benefits include medical, dental, and vision insurance; paid time off and holidays, including a starting bank of 40 hours of PTO for new hires; retirement matching; wellness programs; tuition reimbursement; flexible schedules; hybrid work options; and more.

Essential Duties

• Determine client eligibility by gathering collateral information from hospital, nursing home, long-term skilled home health and home-based 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 various Medicaid programs (e.g., Home and Community Based Services (HCBS), Elderly, Blind, and Disabled, Mentally Ill, Persons Living with AIDS, Brain Injury, Children's HCBS, Total Long-Term Care, Program of All Inclusive Care of the Elderly, Home Care Allowance, and Nursing Home programs).
• Maintain client care plans by reassessing as necessary for the most cost-efficient service plan.
• Adhere to state cost containment regulations.
• Ensure family members are fully informed of options available.
• Make referrals as necessary.
• Consult with state agents.
• Negotiate rates and plans with Medicaid providers and other providers.
• Complete billing paperwork.
• Other duties and responsibilities as assigned.

QUALIFICATIONS

Research shows that women and other underrepresented and historically marginalized groups tend to apply only when they check every box in the posting. If you are reading this and hesitating to click apply for that reason, we encourage you to go for it! A true passion and excitement for making an impact is just as important as work experience.

Minimum Qualifications

• Bachelor's degree in a related field.
• One (1) year of work-related experience.

Preferred Qualifications

• Bilingual in Spanish preferred.
• Able to learn more than one complex computer system and is patient in the learning process.
• Ability to problem-solve by using critical thinking and utilizing resources/researching to find solutions that are best for the family and the department.
• High level organizational and time management skills and thrives with strict deadlines.
• Strong customer service and interpersonal skills with the ability to adapt communication based on level of program knowledge of the audience.
• Warm, empathetic, respectable personality.
• Passionate about agency's mission and vision.

Additional Job Information

A valid Colorado driver's license is required for positions that drive on County Business in either a county or personal vehicle within 30-days of hire or beginning to serve as an intern or volunteer. Offer of employment is contingent upon successful completion of criminal history, motor vehicle report, education verification, and/or references for all positions.

Accommodations Statement

We encourage people with disabilities to apply and are committed to providing reasonable accommodations throughout our hiring process. For assistance with applications, interviews, or other hiring-related accommodations, contact [e-mail]. This contact is for accommodation requests only and cannot provide application status updates.

Equal Opportunity Statement

Jefferson County is an equal opportunity employer, providing equal employment opportunity to all qualified persons. The County affirms the rights of all employees and applicants for employment to be protected from discrimination, intimidation, physical harm and harassment based on race, color, religion, sex, national origin, age, disability, sexual orientation, genetic information, hairstyle associated with racial identity or any other status protected by Federal or State law.

Questions? Contact the Jefferson County Recruitment Team at 303-271-8420 or [e-mail]