LTSS Service Care Manager

Spectraforce Technologies

United States, North Carolina, Raleigh

500 West Peace Street (Show on map)

Apr 29, 2025

Title: LTSS Service Care Manager

Location: Region - 5 Pinellas (must reside in region 5, in Pinellas County)

Duration: 3 months with intent to convert

Shift: 8:00 AM - 5:00 PM, Mon-Fri

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 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.

Monthly and quarterly member contact and will include 80% travel. Remote role. Will require a driver's license.
Managing a case load for healthcare members with long term care needs.
Geriatric long term care
Member assessments and notes.
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 provider s through in person visits and telephonic contact
Authorize 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.
Authorize 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.

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:

Discharge Planning

Disqualifiers:

Not having field experience
Not having previous experience with high caseloads
Not at least meeting 40 WPM on typing test

Performance indicators: Bilingual always preferred - req will indicate if Bilingual is required via the notes section

Candidate Requirements
Education/Certification	Required: Requires a Bachelor's degree and 2 - 4 years of related experience. (Bachelors Degree should be within the realm of Healthcare) - Psychology, Sociology, etc. Field experience would need to be long term to have the team consider someone that does not have a degree within the space they are looking for.	Preferred: n/a
Licensure	Required: Valid driver's license	Preferred: n/a