LTSS Service Care Manager

Position Title: LTSS Service Care Manager

Work Location: Candidates must reside within the state of Florida – Region H (specific zip codes: 33311, 33308, 33306, 33304, 33309, 33069, 33060, 33062, 33064, 33066, 33334, 33325, 33324, 33332, 33029, 33317). Spanish speaking preferred.

Assignment Duration: 3 months (Contract to Hire)

Work Schedule: Monday – Friday 8 am – 5 pm

Work Arrangement: Field-based with significant travel (3-4 days/week within region).

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.

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.

• Must have 2 years of Care Management experience (field experience is a must).

• Home Health Experience.

• Long Term Care Medicaid experience.

• Medicaid / Medicare experience.

• Experience managing high caseloads (50-120 members, geriatric focus).

• Experience with electronic medical health records.

Candidate Requirements

Required: Requires a Bachelor's degree and 2 – 4 years of related experience

Preferred:

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

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.