Position Title: LTSS Service Care Manager
Work Location: Del Rio, 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:
Key Responsibilities:
SC will be assessing the member for approval or denial of personal attendant services to assist with Activities of daily living by filling out a H2060 form in the field.
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 have 5+ years working with aged, blind, or disabled population.
Bilingual strongly preferred.
Microsoft Office experience (Outlook, Word, Excel, etc...).
Education/Certification |
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.
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Licensure |
Required: n/a |
Preferred: n/a |
- Years of experience required
- Disqualifiers
- Best vs. average
- Performance indicators
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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/ Case Management Experience
Disqualifiers: n/a
Performance indicators: n/a
Best vs. average: see below skills |
- Top 3 must-have hard skills
- Level of experience with each
- Stack-ranked by importance
- Candidate Review & Selection
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1 |
Aged, Blind or Disabled Population experience |
2 |
Bilingual |
3 |
Microsoft Office experience (Outlook, Word, Excel, etc...) |
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