Clinical - LTSS Service Care Manager - J01031

Location : Must be local to Rocky Mount, NC. In person visits 3-4 days a week in field. Case load daily 2-3 a day. Field visits will be 2.5-2.75 hr one way radius from home residence for face to face member visits... mileage and lodging (if needed) is reimbursed.

SHIFT : Training 8-5 Mon-Fri EST learning journey is 4 weeks CAMERA ON NO TIME OFF (please ensure the candidates are aware they can t miss training)

Duration : 6 months, possible extension.

Requirement : MUST HAVE RN and / or LCSW / LCSW-A / BSN

Day to Day Responsibilities of this Position and Description of Project :

Case load daily 2-3 a day

In person visits 3-4 days a week in field

Managing a case load for healthcare members with LTSS (Long Term Support / Services) needs.

Monthly and quarterly member contact and will include 80% travel. Remote role. Will require a driver s license.

Member assessments and notes.

Complete assessments with members, caregivers, or providers to obtain information regarding client status, support system, and need for services for care plan development.

Monitor delivery of services and follow-up with members, caregivers, or provider s through in person visits and telephonic contact

Authorize and coordinate referral for services.

Ensure provider services are delivered without gaps and identify functional deficiencies in plans of care.

Assist in coordinating the development of informal or voluntary services to integrate into the member care plan Collaborate with discharge planners, physicians, and other parties to ensure appropriate discharge plan, care plan, and coordination of acute care and long-term care services!

Assist member with filing and resolving complaints and appeals.

• Walk me through the day-to-day responsibilities and a description of the project (Outside of the Workday JD).
• What are performance expectations / metrics?
• What makes this role unique?

Day to Day Responsibilities of this Position and Description of Project :

Managing a case load for healthcare members with LTSS (Long Term Support / Services) needs.

Monthly and quarterly member contact and will include 80% travel. Remote role. Will require a driver s license.

Member assessments and notes.

Complete assessments with members, caregivers, or providers to obtain information regarding client status, support system, and need for services for care plan development.

Monitor delivery of services and follow-up with members, caregivers, or provider s through in person visits and telephonic contact

Authorize and coordinate referral for services.

Ensure provider services are delivered without gaps and identify functional deficiencies in plans of care.

Assist in coordinating the development of informal or voluntary services to integrate into the member care plan Collaborate with discharge planners, physicians, and other parties to ensure appropriate discharge plan, care plan, and coordination of acute care and long-term care services!

Assist member with filing and resolving complaints and appeals.

Licensed Clinical Social Worker / Registered Nurse License and 2+ years of physical health care management experience, 4-6+ years of physical health care management experience preferred. Hospital CM, Home health, discharge planning, or long-term care experience preferred. Licenses / Certifications : Valid driver's license

Candidate Requirements

Education / Certification

Required : Bachelor s

Preferred : Licensure

Required : RN and / or LCSW / LCSW-A / BSN

Preferred : Licensure

Home health experience

Disqualifiers : No Psych experience such as counseling (must have bedside case management hospital physical as well) no Right out of nursing school. No Nursing homes. No rehab.

Additional qualities to look for : Virtual, All Microsoft office, Experience with electronic medical health records

RN and / or LCSW

Physical hospital Health, Care Management, Utilization Mgt, Home Health all and / or background

Microsoft office

Bedside care management