LTSS Service Care Manager

Centene Management Company LLC; Town of Florida (NY); Hybrid; USD 37,000 - 68,000; Full time

Benefits offered by this job

Competitive pay

Health insurance

401K and stock purchase plans

Tuition reimbursement

Paid time off plus holidays

Flexible work arrangements (remote,hyb

Job summary

Centene Management Company LLC is seeking a field-based Care Management Specialist in Florida to assess member needs, develop long-term care plans, and coordinate services with providers and family caregivers.

The role emphasizes strong assessment, communication, and organizational skills, with a Monday–Friday schedule and potential field visits to ensure access to services and adherence to plans.

Qualifications

• Experience interviewing and assessing member needs.
• Knowledge and experience regarding caseload management and casework practices.
• Knowledge regarding determining eligibility for DHSS programs.
• Knowledge regarding Federal and State law as it applies to DHSS programs.
• Ability to collaborate with caregivers and providers.

Responsibilities

• Evaluates the needs of the member and recommends the plan for best outcome.
• Assists with developing long-term care plans and identifies providers and resources.
• Coordinates between member/family and care provider team to ensure services are accessible.
• Provides resource support for housing, employment, etc., based on service plans.
• Monitors care plans and recommends actions based on member needs.
• Interacts with long-term care providers and partners to meet member needs.
• Maintains member information to ensure regulatory compliance.
• May perform home visits to assess needs and collaborate with providers.
• Delivers education to members and caregivers on procedures and services.
• Provides leadership feedback to improve quality of care and cost-effectiveness.
• Performs other duties as assigned.
• Complies with policies and standards.

Skills

Interviewing

Caseload management

DHSS eligibility

Cultural competency

Collaboration with caregivers

Education

Bachelor's degree

Job description

Position Purpose

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 Details

This is a field-based position, and applicants must reside in West Palm Beach, Florida. The ideal candidate should have experience with LTSS and Medicaid managed care, as well as experience working with HCBS. Strong assessment skills, excellent communication and customer service skills, computer proficiency, strong organizational and management skills, and effective time management skills are essential for success in this role. The standard work schedule is Monday through Friday, from 8:00 AM to 5:00 PM.

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.

Education / Experience

Requires a Bachelor's degree and 2-4 years of related experience. or Individuals with a Bachelor's degree in health, human, social work or education services with one or more years of qualifying experience; or 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.

Experience & Skills

• Experience interviewing and assessing member needs.
• Knowledge and experience regarding caseload management and casework practices.
• Knowledge regarding determining eligibility for DHSS programs.
• Knowledge regarding Federal and State law as it applies to DHSS programs.
• The ability to effectively solve problems and locate community resources.
• The ability to collaborate with caregivers, involved State agency representatives and providers.
• Good interpersonal skills.
• Ability to practice Cultural Competency with awareness and respect for diversity.
• Knowledge of the needs and service delivery system for all populations in the case manager's caseload.
• Or equivalent experience acquired through accomplishments of applicable knowledge, duties, scope and skill reflective of the level of this position.

Pay Range

$27.02 - $48.55 per hour

Benefits

• competitive pay
• health insurance
• 401K and stock purchase plans
• tuition reimbursement
• paid time off plus holidays
• flexible approach to work with remote, hybrid, field or office work schedules

Additional Compensation

Actual pay will be adjusted based on an individual's skills, experience, education, and other job-related factors permitted by law, including full-time or part-time status. Total compensation may also include additional forms of incentives. Benefits may be subject to program eligibility.

Equal Opportunity Statement

Centene is an equal opportunity employer that is committed to diversity, and values the ways in which we are different. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, or other characteristic protected by applicable law. Qualified applicants with arrest or conviction records will be considered in accordance with the LA County Ordinance and the California Fair Chance Act.