LTSS Service Care Manager

Davita Inc.; Avon Park (FL); Remote; USD 60,000 - 84,000; Full time

Job summary

A leading healthcare provider is seeking an LTSS Service Care Manager to support quality care for members. This role involves developing personalized care plans, coordinating with healthcare providers, and evaluating member needs. Candidates should have a Bachelor's degree in a healthcare-related field and field experience in case management.

Qualifications

• Requires a Bachelor's degree with 2+ years of field case management experience.
• Experience with Medicaid/Medicare and high caseload management.
• Bilingual is preferred but not required.

Responsibilities

• Develops and coordinates holistic care management activities.
• Evaluates member needs and facilitates service plans.
• Provides resource support and education to members and their families.

Skills

Field case management

Technology savy

Time management

Education

Bachelor's degree in Healthcare relevant field

Tools

Electronic medical health records

TruCare software

Job description

Title: LTSS Service Care Manager

Duration: 3 Months - With intent to convert

Location: Remote with 80-90% of the time in field

Highlands County - Avon Park (Region 6)

Work Schedule: 8-5 Mon-Fri

Position Summary:

• 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.

Key Responsibilities:

• Evaluates the needs of the member, the resources available, and recommends and/or facilitates the plan for the best outcome.


• Assists with developing ongoing long-term care plans/service plans and works to identify providers, specialist, and/or community resources needed for long-term care.


• Coordinates as appropriate between the member and/or family/caregivers and the care provider team to ensure identified services are accessible to members.


• Provides 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 plans.


• Monitors care plans/service plans, member status and outcomes, as appropriate, and provides recommendations to care plan/service plan based on identified member needs.


• Interacts with long-term care healthcare providers and partners as appropriate to ensure member needs are met.


• Collects, documents, and maintains long-term care member information and care management activities to ensure compliance with current state, federal, and third-party payer regulators.


• May perform home and/or other site visits to assess member's needs and collaborate with healthcare providers and partners.


• Provides and/or facilitates education to long-term care members and their families/caregivers on procedures, healthcare provider instructions, service options, referrals, and healthcare benefits.


• Provides 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 assigned.


• Complies with all policies and standards.


• Complete assessments with members, caregivers, or providers to obtain information regarding client status, support system, and need for services for care plan development.


• Monitor delivery of services and follow-up with members, caregivers, or providers through in person visits and telephonic contact.


• Authorize and coordinate referral for services.


• Ensure provider services are delivered without gaps and identify functional deficiencies in plans of care.


• Assist in coordinating the development of informal or voluntary services to integrate into the member care plan.


• Collaborate with discharge planners, physicians, and other parties to ensure appropriate discharge plan, care plan, and coordination of acute care and long-term care services.


• Assist member with filing and resolving complaints and appeals.

Qualification & Experience:

Candidate Requirements
Education/Certification	Required: Requires a Bachelor's degree and 2 - 4 years of related experience. (Bachelors Degree should be within the realm of Healthcare) - Psychology, Sociology, etc. Field experience would need to be long term to have the team consider someone that does not have a degree within the space they are looking for.	Preferred: n/a
Licensure	Required: Valid driver's license	Preferred: n/a
Years of experience required Disqualifiers Best vs. average Performance indicators	Must haves: 2+ years of Care Management experience (field experience is a must) Caseloads of 50,60,70 members - bonus if it is geriatric Long Term Care Medicaid experience Medicaid / Medicare experience Need to see experience being able to manage high case load Fast paced environment regarding new processes and programs They must be comfortable being able to connect with IT should their equipment fail in the field, etc. or be able to go into an office location or IT space. All documentation must be within system within 24 hours of completion Experience with electronic medical health records Home Health Experience Nice to haves: Discharge Planning Working with TruCare which is the software the team uses Disqualifiers: Not having field experience Not having previous experience with high caseloads Performance indicators: Bilingual always preferred - req will indicate if Bilingual is required via the notes section
Top 3 must-have hard skills Level of experience with each Stack-ranked by importance Candidate Review & Selection	1	2 years of field case management
2	Technology Savy
3	Must be able to look at calendar and manage time - ensuring enough time for documentation

Position is offered by a no fee agency.