LTSS Service Care Manager; RN

Overview

Position Title: LTSS Service Care Manager (RN)

Work Location: Member-Facing - Charlotte - NC

Assignment Duration: 3 Months Contract to Hire

Work Schedule: 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).

Schedule:

8-5 Mon-Fri EST

NOTE FROM HM: 2.5-2.75 hr one way radius from home residence for face to face member visits; mileage and lodging (if needed) is reimbursed.

Assists in developing, assessing, and coordinating holistic care management activities to enable quality, cost-effective healthcare outcomes. Develops or assists 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.

• 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 providers 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 and long-term care services.
• Assist member with filing and resolving complaints and appeals.

Candidate Requirements

• Education/Certification –
  
  Required:
  
  Graduate from an accredited School of Nursing or a Bachelor's degree with 2-4 years of related experience. Preferred: as applicable.
• Licensure –
  
  Required:
  
  RN
• Years of experience: 2-4+ years of physical health care management experience; 4-6+ years preferred. Hospital case management (CM), home health, discharge planning, or long-term care experience preferred. Home health experience is a plus.
• Disqualifiers:
  No psychology/counseling experience; bedside case management hospital experience preferred; avoid candidates with nursing homes or rehab only backgrounds.
• Additional qualities:
  Virtual capability, proficient with Microsoft Office, and experience with electronic medical records.