Pediatric Senior LTSS Service Care Manager

Pediatric Senior LTSS Service Care Manager

Requirements

• Requires a Bachelor’s degree and 4 – 6 years of related experience Or equivalent experience acquired through accomplishments of applicable knowledge, duties, scope and skill reflective of the level of this position.
• Licensed Practical Nurse with 2 years of Pediatric experience

Responsibilities

• Assists with developing and continuously assessing ongoing long-term care plans and works to identify providers, specialist, and/or community resources needed for long-term care
• Coordinates and manages as appropriate between the member and/or family/caregivers and the care provider team to ensure identified services are accessible to members
• Monitors care plans/service plans, member status and outcomes, as appropriate, and provides recommendations to care plan/service plan based on identified member needs
• Identifies problems/barriers for long-term care management and appropriate care management interventions
• 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
• Reviews long-term care member data to identify trends and improve operating performance and quality care in accordance with state and federal regulations
• Reviews referrals information and intake assessments to assist with developing appropriate long-term care plans/service plans
• Collaborates with healthcare providers/partners as appropriate to facilitate member care to ensure member needs are met and determine a revised service plan/care plan for member if needed
• May perform home and/or other site visits to assess member’s needs and collaborate with healthcare providers and partners
• 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
• Provides and/or facilitates education to members and their families/caregivers on procedures, healthcare provider instructions, service options, referrals, and healthcare benefits
• Partners with leadership team to improve and enhance quality of care and service delivery for long-term members in a cost-effective manner
• Provides overall guidance and training to other team members within team
• May assist with additional assignments, projects or other support as needed
• Performs other duties as assigned
• Complies with all policies and standards

Preferred Qualifications

No preferred qualifications provided.