LTSS Service Care Manager

Spectraforce Technologies; Beaufort (NC); On-site; USD 65,000 - 85,000; Full time

Job summary

Spectraforce Technologies seeks a LTSS Service Care Manager in the Pitt County, NC area to coordinate holistic care management for long-term care members. You will develop service plans, educate members and families, and support both member and provider interactions in a hybrid field/remote setting.

The role involves managing a case load, regular member contacts with substantial travel, and collaboration with discharge planners and physicians to ensure seamless care planning and appropriate

Qualifications

• Bachelor's degree is required.
• RN and/or LCSW/LCSW-A/BSN/ADN licensure is required.
• 2–4+ years of physical health care management experience; 4–6+ years preferred.
• Experience with discharge planning, home health, and case management.

Responsibilities

• Manage a case load for LTSS needs.
• Monthly and quarterly member contact with travel.
• Perform member assessments and develop care plans.
• Coordinate referrals and monitor service delivery.
• Collaborate with discharge planners, physicians, and care providers.

Skills

Bedside care management

Care Management

Utilization Management

Microsoft Office

Electronic Medical Records (EMR)

Education

Bachelor's

Tools

Microsoft Office

Electronic Medical Records (EMR)

Job description

Position Title: LTSS Service Care Manager

Work Location: Pitt County, NC area (candidates must be within up to 2.5-hour one-way radius from home residence for face-to-face member visits; mileage and lodging reimbursed if needed)

Assignment Duration: 6 months (possibility to extend or convert)

Work Schedule: 8-5 Mon-Fri EST

Work Arrangement: Hybrid (Remote 1-2 admin days a week; In-person visits 3-4 days a week in field; up to 1-4 visits a day. Quarterly in-office team meeting/training at Raleigh or Charlotte locations)

Position Summary

Assists in developing, assessing, and coordinating holistic care management activities to enable quality, cost-effective healthcare outcomes. Will 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. Member facing but potentially provider facing.

Key Responsibilities

• Managing a case load for healthcare members with LTSS (Long Term Support/Services) needs.
• Monthly and quarterly member contact and will include 80% travel. Remote role. Will require a driver's license.
• Member assessments and notes.
• 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.

Education/Certification

Required: Bachelor's

Preferred:

Licensure

Required: RN and/or LCSW/LCSW-A/BSN/ADN

Preferred:

Years of experience required

Years of experience required: 2-4+ years of physical health care management experience, 4-6+ years of physical health care management experience preferred. Hospital CM, Home health, discharge planning, or long-term care experience preferred. Case management and care planning experience.

Preferred - Home health experience, community health/member facing, discharge planning

Preferred - Home health experience, community health/member facing, discharge planning

Disqualifiers

Disqualifiers: No Psych experience such as counseling (must have bedside case management hospital physical as well) no Right out of nursing school. No Nursing homes. No rehab.

Additional qualities to look for

Additional qualities to look for: Virtual, All Microsoft office, Experience with electronic medical health records

Top 3 must-have hard skills stack-ranked by importance

• Physical hospital Health, Care Management, Utilization Mgt, Home Health - all and/or background
• Microsoft office - Tech savvy
• Bedside care management