LTSS Service Care Manager

Spectraforce Technologies; Concord (NC); Hybrid; USD 65,000 - 90,000; Full time

Job summary

Spectraforce Technologies seeks an LTSS Service Care Manager to develop and coordinate holistic care plans for long-term care members, educating families about services and benefits, and coordinating with providers to ensure seamless care.

The role is 6 months with hybrid work: 1-2 admin days remotely and 3-4 in-person visits weekly, up to 80% travel, requiring 2-4+ years in health care management and applicable licensure.

Qualifications

• 2-4+ years of physical health care management experience; 4-6+ years preferred.
• Hospital CM, Home health, discharge planning, or long-term care experience preferred.
• Disqualifiers: No Psych experience such as counseling; no nursing homes or rehab.
• Experience with electronic medical health records (EMR/EHR) is preferred.

Responsibilities

• Manage a caseload for LTSS needs.
• Monthly and quarterly member contact with up to 80% travel.
• Complete assessments with members, caregivers, or providers for care plan development.
• Monitor service delivery and follow up via in-person visits and calls.
• Authorize and coordinate referrals for services.
• Ensure provider services are delivered without gaps and identify deficiencies in plans of care.
• Coordinate informal or voluntary services to integrate into the care plan.
• Collaborate with discharge planners, physicians, and others to ensure coordinated care.

Skills

Health care management

Microsoft Office

Bedside care

Education

Bachelor's degree

RN or LCSW

Tools

EMR / EHR systems

Job description

Position Title

LTSS Service Care Manager

Work Location

Cumberland County, NC (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

ongoing work schedule 8-5 Mon-Fri EST

Training Schedule

Training 8-5 Mon-Fri EST (3.5 weeks, cameras on, no time off)

Work Arrangement

Hybrid - Remote 1-2 admin days per week; in-person member visits 3-4 days per week in the field (up to 1-4 visits per day; longer drive times may mean only 1 visit/day)

Quarterly team meetings/training at Raleigh or Charlotte office 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.
• 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:

Experience

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

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: Virtual, All Microsoft office, Experience with electronic medical health records

Key Skills

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

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