LTSS Service Care Manager
7 days ago
You could be the one who changes everything for our 28 million members. Centene is transforming the health of our communities, one person at a time. As a diversified, national organization, you'll have access to competitive benefits including a fresh perspective on workplace flexibility.
- 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.
Or equivalent experience acquired through accomplishments of applicable knowledge, duties, scope and skill reflective of the level of this position.
License/Certification:
- For Iowa Only: Bachelor's degree with 30 semester hours or equivalent quarter hours in a human services field (including, but not limited to, psychology, social work, mental health counseling, marriage and family therapy, nursing, education, occupational therapy, and recreational therapy) and at least two years of experience in the delivery of services to the population groups or current state's Registered Nurse (RN) license and at least four years of experience required
- For North Carolina Standard Plan: Two (2) years of prior LTSS and/or HCBS coordination, care delivery monitoring and care management experience; Prior experience with social work, geriatrics, gerontology, pediatrics, or human services.
- RN or LCSW required.
- For North Carolina Tailored Plan: Two (2) years of prior LTSS and/or HCBS coordination, care delivery monitoring and care management experience; Prior experience with social work, geriatrics, gerontology, pediatrics, or human services.
- RN or LCSW / LCSW-A preferred
- For Florida LTSS ECC, must have 2 years of youth/young adult experience required
- For Hawaii: Current Hawaii Registered Nurse (RN) License. required
- For Arkansas Total Care plan - This position is designated as safety sensitive in Arkansas and requires a driver's license, child and adult maltreatment check (before hire and recurring), and a drug screen (at time of hire and recurring). Must reside in AR or border city. Travel: 5%. required
Centene offers a comprehensive benefits package including: competitive pay, health insurance, 401K and stock purchase plans, tuition reimbursement, paid time off plus holidays, and a flexible approach to work with remote, hybrid, field or office work schedules. Actual pay will be adjusted based on an individual's skills, experience, education, and other job-related factors permitted by law, including full-time or part-time status. Total compensation may also include additional forms of incentives. Benefits may be subject to program eligibility.
Centene is an equal opportunity employer that is committed to diversity, and values the ways in which we are different. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, or other characteristic protected by applicable law.
Qualified applicants with arrest or conviction records will be considered in accordance with the LA County Ordinance and the California Fair Chance Act
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