LTSS Service Care Manager
Spectraforce
US
Remote
a month ago
Job Description
Position Title: LTSS Service Care Manager
Work Location: Odessa/Andrews/Fort Stockton, Pecos/Monahans/Kermit, and Alpine TX
Assignment Duration: 6 months
Work Schedule: 8am-5pm M-F – overtime may be required at times
Work Arrangement: Remote, member facing
Position Summary: Evaluates the needs of the most complex and high risk members and recommends a plan of care for the best outcome
Background & Context:
- Must meet Quality standards of assessments of 92% or above
- Documentation must be completed for assessments within 3 BD turn around time
- Required travel of 75%
- Mileage reimbursement provided for member facing visits
- Travel within the MRSA West Area 3 days a week, work remotely 2 days
Key Responsibilities: - LTSS service care manager will have 3 days of travel for visits seeing the members in their home and 2 days working remote for documentation of assessments as well as any follow up and tasks required to work
- SC will be assessing the member for approval or denial of personal attendant services to assist with Activities of daily living by filling out a H2060 form in the field
- LTSS Service CM will fill out a required assessment and all forms, document their assessments and submitting for authorization or denial of services within a 3Business day turnaround
- Acts as liaison and member advocate between the member/family, physician, and facilities/agencies
- Provides and/or facilitates education to long-term care members and their families/caregivers on topics such as preventive care, procedures, healthcare provider instructions, treatment options, referrals, prescribed medication treatment regimens, and healthcare benefits
- Educates on and coordinates community resources, to include medical and social services
- Provides coordination of service authorization to members and care managers for various services based on service assessment and plans (e.g., meals, employment, housing, foster care, transportation, activities for daily living)
- Ensures appropriate referrals based on individual member needs and supports the identification of providers, specialists, and community resources
- Ensures identified services are accessible to members
- Maintains accurate documentation and supports the integrity of care management activities in the electronic care management system
- Works to ensure compliance with clinical guidelines as well as current state and federal guidelines
- 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: - Required: Bachelor's degree and 2 – 4 years of related experience or LVN and 2 – 4 years of related equivalent experience
- Preferred: Prefer Social Work, LVN, Medical background that would require at least a bachelor’s degree
- Must haves: Working the aged, blind or disabled population 5+ years or more. Bilingual strongly preferred
- Nice to haves: Social Service/ Social Work/ Care Management / Services Coordination Or equivalent experience acquired through accomplishments of applicable knowledge, duties, scope and skill reflective of the level of this position. Nursing/ LVN/ Medical/ Case Management Experience
Education/Certification | Required: Bachelor's degree and 2 – 4 years of related experience or LVN and 2 – 4 years of related equivalent experience | Preferred: Prefer Social Work, LVN, Medical background that would require at least a bachelor’s degree. | ||
Licensure | Required: n/a | Preferred: n/a | ||
| Must haves: Working the aged , blind or disabled population 5+ years or more. Bilingual strongly preferred Nice to haves: Social Service/ Social Work/ Care Management / Services Coordination Or equivalent experience acquired through accomplishments of applicable knowledge, duties, scope and skill reflective of the level of this position. Nursing/ LVN/ Medical/ Case Management Experience Disqualifiers: n/a Performance indicators: n/a Best vs. average: see below skills | |||
| 1 | Aged, Blind or Disabled Population experience | ||
2 | Bilingual | |||
3 | Microsoft Office experience (Outlook, Word, Excel, etc…) |
Applicant Notices & Disclaimers
- For information on benefits, equal opportunity employment, and location-specific applicant notices, click here
At SPECTRAFORCE, we are committed to maintaining a workplace that ensures fair compensation and wage transparency in adherence with all applicable state and local laws. This position’s starting pay is: $ 24.00/hr.