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LTSS Service Care Manager
Spectraforce
US
Remote

a month ago

Job Description

Position Title: LTSS Service Care Manager
Work Location: 
Florida - Pinellas County (All candidates must reside in Pinellas- Spanish speaking is preferred)
Assignment Duration: 12 months (Possible extension OR conversion)
Work Schedule:
8-5 Mon-Fri
Work Arrangement: Field-based / Member-facing (80-90% )

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: Sunshine State Health Plan role focused on geriatric long-term care with significant field work.

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.
• Valid driver's license required.
• For specific states, additional requirements apply (e.g., RN or LCSW in some plans).

Working Conditions & Physical Demands: Will be in the field 80-90% of the time. 8-5 Mon-Fri. Requires driver's license and comfort with member-facing field work and travel.
 

Candidate Requirements
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  
Required: Valid driver's license Preferred: n/a  
  • Years of experience required
  • Disqualifiers
  • Best vs. average
  • Performance indicators
Must 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 Experience
 
Nice to haves:
  1. Discharge Planning
  2. Working with TruCare which is the software the team uses
Disqualifiers:
  • Not having field experience
  • Not having previous experience with high caseloads
 
Performance indicators: Bilingual always preferred – req will indicate if Bilingual is required via the notes section
 
  • Top 3 must-have hard skills
  • Level of experience with each
  • Stack-ranked by importance
  • Candidate Review & Selection
1 2 years of field case management
2 Technology Savy
3 Must be able to look at calendar and manage time - ensuring enough time for documentation
 
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 pay range is $26.00/hr - $29.00/hr.

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