LTSS Service Care Manager

Position Title : LTSS Service Care Manager Work Location : Hamilton County, Florida Assignment Duration : 12 Months (possibility to extend or convert) Work Schedule : 8-5 Mon-Fri Work Arrangement : Remote with 80-90% field work 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. Background & Context : Supports our organization's Sunshine State Health Plan in delivering long-term care services to members. Doesn't need to be Spanish speaking. 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 Qualification & Experience : * Requires a Bachelor's degree and 2 - 4 years of related experience. * Or equivalent experience acquired through accomplishments of applicable knowledge, duties, scope and skill reflective of the level of this position. 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 indicatorsMust 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 ExperienceNice to haves:* Discharge Planning * Working with TruCare which is the software the team usesDisqualifiers:* Not having field experience * Not having previous experience with high caseloadsPerformance indicators: Bilingual always preferred - req will indicate if Bilingual is required via the notes section Position is offered by a no fee agency.