LTSS Service Care Coordinator

LTSS Service Care Coordinator

Requirements

• Requires a Bachelor’s degree and 1 year of related experience, or equivalent experience acquired through accomplishments of applicable knowledge, duties, scope and skill reflective of the level of this position.
• Direct experience working with individuals who have disabilities and/or with vulnerable populations who have chronic or complex conditions, including children and young adults within three of the last five years. Other state specific requirements may apply.

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 on-site visits to assess member’s needs and collaborates with providers or resources, as appropriate
• 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

Preferred Qualifications

• 3 – 5 years of verifiable employment in any of the following Human and Social Services work settings: Child and Family Services, Early Child Development, Child or Adolescent Guidance and Counseling, Prekindergarten – 12 Education, Child/Adolescent Rehabilitation Counseling services, Pediatric Clinics or Hospitals, or Pediatric Home Health
• Experience conducting comprehensive assessments and provision of formal healthcare/behavioral services with children, adolescents, or young adults (0 – 21) under Medicaid – STAR Health, CHIP, STAR Kids, or Foster Care or CPS recipients.
• Experience working in Call Center Operations environments and managing high volume caseloads
• Role requires strong adaptability, flexibility, and resiliency skills.
• Professional business phone etiquette skills and proficient computer skills and experience working within large databases or provider information systems and Microsoft Office applications.
• Experience working in managed care environment is a plus (Federal and State Sponsored Govt Programs), but not required