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.

For Iowa Only: Bachelor's 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 state's Registered Nurse (RN) license and at least four years of experience required

For North Carolina Standard Plan: Two (2) years of prior LTSS and/or 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 and/or HCBS coordination, care delivery monitoring and care management experience; Prior experience with social work, geriatrics, gerontology, pediatrics, or human services. RN or LCSW / LCSW-A preferred