New
LTSS Service Care Manager - J01031
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![]() United States, North Carolina, Raleigh | |
![]() 500 West Peace Street (Show on map) | |
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Job Profile SummaryPosition Purpose:Assists in developing, assessing, and coordinating holistic care management activities to enable quality, costeffective healthcare outcomes. May develop or assist with developing personalized service care plansservice plans for longterm care members and educates members and their familiescaregivers on services and benefits available to meet member needs.EducationExperience:Requires a Bachelors 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.LicenseCertification: For Iowa Only: Bachelors degree with 30 semester hours or equivalent quarter hours in a human services field including, but not limited to, psychology, social work, mental health counseling, marriage and family therapy, nursing, education, occupational therapy, and recreational therapy and at least two years of experience in the delivery of services to the population groups or current states Registered Nurse RN license and at least four years of experience required For North Carolina Standard Plan: Two 2 years of prior LTSS andor HCBS coordination, care delivery monitoring and care management experience Prior experience with social work, geriatrics, gerontology, pediatrics, or human services. RN or LCSW required. For North Carolina Tailored Plan: Two 2 years of prior LTSS andor HCBS coordination, care delivery monitoring and care management experience Prior experience with social work, geriatrics, gerontology, pediatrics, or human services. RN or LCSW LCSWA preferred For Arkansas Total Care plan This position is designated as safety sensitive in Arkansas and requires a drivers license, child and adult maltreatment check before hire and recurring, and a drug screen at time of hire and recurring. Must reside in AR or border city. Travel: 5. requiredResponsibilitiesEvaluates the needs of the member, the resources available, and recommends andor facilitates the plan for the best outcomeAssists with developing ongoing longterm care plansservice plans and works to identify providers, specialist, andor community resources needed for longterm careCoordinates as appropriate between the member andor familycaregivers and the care provider team to ensure identified services are accessible to membersProvides resource support to members and their familiescaregivers for various needs e.g. employment, housing, participant direction, independent living, justice, foster care based on service assessment and plansMonitors care plansservice plans, member status and outcomes, as appropriate, and provides recommendations to care planservice plan based on identified member needsInteracts with longterm care healthcare providers and partners as appropriate to ensure member needs are metCollects, documents, and maintains longterm care member information and care management activities to ensure compliance with current state, federal, and thirdparty payer regulatorsMay perform home andor other site visits to assess members needs and collaborate with healthcare providers and partnersProvides andor facilitates education to longterm care members and their familiescaregivers on procedures, healthcare provider instructions, service options, referrals, and healthcare benefitsProvides feedback to leadership on opportunities to improve and enhance quality of care and service delivery for longterm care members in a costeffective mannerPerforms other duties as assignedComplies with all policies and standards |