LTSS Service Care Manager

Position Title: LTSS Service Care Manager

Work Location: 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: Remote, member facing

Position Summary: Evaluates the needs of the most complex and high risk members and recommends a plan of care for the best outcome

Background & Context:

• 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
  
  Key Responsibilities:
• 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
• 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
• 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/ Case Management Experience