LTSS Service Care Manager

Position Title: LTSS Service Care Manager

Work Location: McAllen or Mission, TX

Assignment Duration: 3 months

Work Schedule: 8am-5pm, possibility of OT

Work Arrangement: Remote (Member-facing)

Position Summary:

Assists in developing, assessing, and coordinating holistic care management activities to enable quality, cost-effective healthcare outcomes.

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.
• Meet required deadlines, 3-day turnaround time for documentation of any assessment.
• Possibility of High priority assessments that must be completed within 24 hours.
• Possibility of OT needed to address business needs.
• Deliver thorough assessment, clear documentation.
• Deliver quality of all work performed.
• Available to work M-F 8-5, with possibility of work needed outside of 8-5 schedule.
• Good communication skills and collaboration with other Teams, Providers involved with member's care.
• Ability to quickly adapt to change and collaborate well with team members.
• Ability to identify health and safety risks/gaps, holistically assess, and coordinate member care.

• 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.
• Required Licensure: LPN, LVN, LSW, TX Driver License.
• Must haves: Microsoft Outlook, Teams, Excel, Word, Adobe, minimum of 50 wpm typing speed.
• Nice to haves: Field Work experience with the elderly and disabled population.
• Top 3 must-have hard skills:
  
  
  
  • Speak/Write English & Spanish.
  • Know/Understand Medical Terminology and Disease Process.
  • 2+ years of experience in a managed care environment or working with people with disabilities and vulnerable populations who have chronic or complex conditions.