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Job description
Position Title : LTSS Service Care Manager
Work Location : Spanish-speaking (Pembroke Pines, Miramar, Hallandale, Weston, Dania, or Davie areas)
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Assignment Duration : 3 months (Contact to hire)
Work Schedule : Monday - Friday, 8 am - 5 pm
Work Arrangement : Field-based (80% travel expected); remote role requiring a driver's license; candidates must reside in the specified Broward area
Position Purpose:
Assists in developing, assessing, and coordinating holistic care management activities to enable quality, cost-effective healthcare outcomes. May develop or assist with developing personalised 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 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, specialists, 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 regulations
* 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
* 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
* Authorise 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
Candidate Requirements Education/Certification Required: Requires a Bachelor's degree and 2 - 4 years of related experience Preferred: Licensure Required: i.e. RN, BSN, LPN, etc. Preferred: Years of experience required
Disqualifiers
Best vs. average
Performance indicators
Must haves: 2+ years of Care Management experience (field experience is a must)
Home Health Experience
Long Term Care Medicaid experience
Medicaid / Medicare experience
Need to see experience being able to manage high case load - Caseloads of 50,60,70 members who are 65 years of age and above team is not looking for pediatric experience
Experience with electronic medical health records
Nice to haves: Team has noticed that people that perform well in this role are those that have case management experience
Field based experience with managing a caseload similar to the one noted for this team (60-120 members)
Individuals with previous DFPS experience
Disqualifiers: Having telephonic customer service calls is not what the team is seeking in regard to case management. They are really seeking someone with in the field case management experience
Not having field experience
Not having previous experience with high caseloads
Not at least meeting 40 WPM on typing test
Top 3 must-have hard skills
Level of experience with each
Stack-ranked by importance
Candidate Review & Selection
1 2+ years of Care Management experience (field experience is a must)
2 Home Health Experience 3 Experience with electronic medical health records
Who can apply
Review the original listing for work authorization, qualifications and employer requirements.