LTSS Service Care Manager

Spectraforce Technologies, Inc.; Lake Wales (FL); Hybrid; USD 52,000 - 76,000; Full time

Job summary

Spectraforce Technologies, Inc. is seeking a LTSS Service Care Manager in Florida to manage long-term care cases, perform member assessments, and coordinate care plans with caregivers, providers, and discharge planners.

The role requires a Bachelor’s in a healthcare field and 2–4 years of CM experience. The position involves 80% travel, driver’s license, and is structured as a 12-month assignment with the potential to convert based on performance.

Qualifications

• Requires a Bachelor’s degree in a healthcare field such as Psychology, Sociology, or related discipline.
• 2–4 years of related care management experience; field experience strongly preferred.

Responsibilities

• Manage a care caseload of healthcare members with long-term care needs.
• Conduct member assessments and develop care plans with input from members, caregivers, and providers.
• Coordinate and authorize referrals for services and monitor service delivery.
• Maintain timely documentation within the system (within 24 hours).
• Travel up to ~80% for home visits and in-person encounters; ensure timely follow-up.

Skills

Care management

Field experience

High caseload

Medicaid/Medicare experience

Education

Bachelor's degree in healthcare

Tools

TruCare

EMR/EHR systems

Job description

Position Title: LTSS Service Care Manager

Work Location: FL-County Polk /Lake Wales (bi lingual Spanish preferred but not required)

Assignment Duration: 12 months with intent to convert

Work Schedule: 8-5 Mon-Fri

Work Arrangement: 1-2 days remote, 3-4 days home visits

Responsibilities

• Monthly and quarterly member contact and will include 80% travel. Remote role. Will require a driver's license.
• Managing a case load for healthcare members with long term care needs.
• Geriatric long term care
• 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 provider s 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
• Working with members in a face-to-face environment
• This position does have the intent to convert based on performance and eligibility
• Independent work
• Each member must be contacted once per month, and some may need to be seen
• 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

Candidate Requirements

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.

Required: Valid driver's license

• 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

1. Discharge Planning
2. 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

• 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