Position Title: LTSS Service Care Manager
Work Location: Source from Odessa/Andrews/Fort Stockton, Pecos/Monahans/Kermit and Alpine TX
Assignment Duration: 6 months
Work Schedule: 8am-5pm M-F - overtime may be required at times
Work Arrangement: Travel within the MRSA West Area 3 days a week , work remotely 2 days .
Position Summary: Health plan or business unit * Team culture * Surrounding team & key projects * Purpose of this team * Reason for the request * Motivators for this need * Any additional upcoming hiring needs? (first non?task sentence chosen)
Key Responsibilities:
Must meet Quality standards of assessments of 92% or above
Documentation must be completed for assessments within 3 BD turn around time
Required travel of 75%
Mileage reimbursement provided for member facing visits
Travel within the MRSA West Area 3 days a week , work remotely 2 days .
LTSS service care manager will have 3 days of travel for visits seeing the members in their home and 2 days working remote for documentation of assessments as well as any follow up and tasks required to work .
LTSS Service CM will fill out a required assessment and all forms, document their assessments and submitting for authorization or denial of services within a 3Business day turnaround.
Evaluates the needs of the most complex and high risk members and recommends a plan of care for the best outcome
Acts as liaison and member advocate between the member/family, physician, and facilities/agencies
Provides and/or facilitates education to long-term care members and their families/caregivers on topics such as preventive care, procedures, healthcare provider instructions, treatment options, referrals, prescribed medication treatment regimens, and healthcare benefits.
Educates on and coordinates community resources, to include medical and social services. Provides coordination of service authorization to members and care managers for various services based on service assessment and plans (e.g., meals, employment, housing, foster care, transportation, activities for daily living)
Ensures appropriate referrals based on individual member needs and supports the identification of providers, specialists, and community resources. Ensures identified services are accessible to members
Maintains accurate documentation and supports the integrity of care management activities in the electronic care management system. Works to ensure compliance with clinical guidelines as well as current state and federal guidelines
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:
Required: Bachelor's degree and 2 - 4 years of related experience or LVN and 2 - 4 years of related equivalent experience
Preferred: Prefer Social Work, LVN, Medical background that would require at least a bachelor's degree.
Must haves: Working the aged , blind or disabled population 5+ years or more. Bilingual strongly preferred
Nice to haves: Social Service/ Social Work/ Care Management / Services Coordination Or equivalent experience acquired through accomplishments of applicable knowledge, duties, scope and skill reflective of the level of this position. Nursing/ LVN/ Medical
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