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Position Title: LTSS Service Care Manager
Work Location: Candidates must reside within the state of Florida. All candidates must reside in Region H (Broward) - . (cities: Ft. Lauderdale, Deerfield Beach, Pompano Beach, Hollywood or Hallandale). Also, zip codes to source from: 33311, 33308, 33306, 33304, 33309, 33069, 33060, 33062, 33064, 33066, 33334, 33325, 33324, 33332, 33029, 33317
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
Spanish-speaking is preferred
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
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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
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- Top 3 must-have hard skills
- Level of experience with each
- Stack-ranked by importance
- Candidate Review & Selection
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1 |
2+ years of Care Management experience (field experience is a must)
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| 2 |
Home Health Experience |
| 3 |
Experience with electronic medical health records
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