LTSS Service Care Manager

Position Title: LTSS Service Care Manager

Work Location: Remote - Candidates must reside within the state of Florida (Boca Raton, Lake Worth, or West Palm Beach)

Assignment Duration: 12 months with possibility of extension (Contract-to-Hire)

Work Schedule: Monday - Friday | 8:00 AM - 5:00 PM

Work Arrangement: Remote with Field Work

Note: Spanish-speaking candidates preferred. This is a field-based role requiring home visits and travel within the assigned territory.

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.

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 identifies providers, specialists, and community resources needed for long-term care.
• Coordinates between members, families/caregivers, providers, and healthcare teams to ensure services are accessible.
• Provides resource support to members and their families/caregivers for employment, housing, independent living, justice, foster care, and other community resources.
• Monitors care plans, member status, and outcomes, and updates service plans based on identified needs.
• Interacts with long-term care providers and community partners to ensure member needs are met.
• Collects, documents, and maintains member information and care management activities in compliance with state, federal, and payer requirements.
• Performs home and site visits to assess member needs and collaborate with healthcare providers.
• Educates members and caregivers regarding procedures, healthcare services, referrals, and available benefits.
• Provides feedback to leadership on opportunities to improve quality of care and service delivery.
• Performs other duties as assigned and complies with all policies and standards.

Required:

• Bachelor's degree.
• 2-4 years of related experience.

Preferred: N/A.

Required:

• Valid Driver's License.

Preferred: N/A.

• 2+ years of Care Management experience (field experience is required).
• Experience managing caseloads of 50-70 members (geriatric population is a plus).
• Long-Term Care Medicaid experience.
• Medicaid/Medicare experience.
• Experience managing high-volume caseloads.
• Ability to work in a fast-paced environment with changing processes and programs.
• Comfortable troubleshooting technology issues and coordinating with IT while working remotely.
• Complete documentation within 24 hours of member visits.
• Experience with Electronic Medical Records (EMR).
• Home Health experience.

• Experience using TruCare.
• Geriatric case management experience.
• Spanish-speaking candidates preferred.

• No field-based care management experience.
• No experience managing high-volume caseloads.

• Documentation completed within 24 hours.
• Ability to independently manage field schedules.
• Effective management of assigned caseloads.
• Strong communication with members, caregivers, providers, and internal departments.
• Bilingual candidates preferred when indicated.