Long-Term Care Case Manager – In-Home & Facility

Highmark Health; Northern (KY); Hybrid; USD 73,000 - 117,000; Full time

Job summary

Highmark Inc. seeks a remote Care Coordinator to serve as the primary contact for members, coordinating care across home, facility, and community settings. The role requires extensive travel within the assigned territory and delivering case management in nursing facilities and homes.

The position emphasizes LTSS coordination, HCBS/DSNP benefits, and collaboration with interdisciplinary teams to ensure safe, cost-effective care transitions. Excellent documentation is required.

Qualifications

• Bachelor’s degree in Social Work or in health, human, or education services and 3 years of experience in long-term care, home health, hospice, public health, or assisted living.
• Master’s degree in Social Work or in health, human, or education services and 1 year of experience in long-term care, home health, hospice, public health, or assisted living.
• Current State RN or LPN licensure OR Current multi-state licensure through the enhanced Nurse Licensure Compact (eNLC) and 2 years of experience in long-term care, home health, hospice, public health, or assisted living.
• A high school degree or equivalent and three years of qualifying experience with case management of the aged, including management of behavioral health conditions, or persons with physical or developmental disabilities, or HIV/AIDS population.

Responsibilities

• Conduct regular in-home and nursing facility visits to complete face-to-face needs assessments.
• Assess, plan, coordinate, implement and evaluate care for eligible members with chronic and complex needs.
• Coordinate care across LTSS, social, and psychosocial needs in the safest, least restrictive way.
• Authorize LTSS services and coordinate HCBS, Medicaid and DSNP benefits.

Skills

Case management

Travel flexibility

HIPAA compliance

Communication skills

Education

Bachelor's degree in Social Work / health services

Master’s degree in Social Work / health services

RN/LPN license or multi-state licensure (eNLC)

High school diploma + relevant experience

Tools

PC-based word processing

Electronic health records (EHR)

Job description

Highmark Inc. seeks a remote Care Coordinator to serve as the primary contact for members, coordinating care across home, facility, and community settings. The role requires extensive travel within the assigned territory and delivering case management in nursing facilities and homes.

The position emphasizes LTSS coordination, HCBS/DSNP benefits, and collaboration with interdisciplinary teams to ensure safe, cost-effective care transitions. Excellent documentation is required.