Case Manager -LTSS - Mesa County, Colorado in surrounding areas

UnitedHealth Group•Grand Junction, CO

10d•$29 - $52•Remote

About The Position

The Case Manager supports corporate objectives by applying expertise in Long Term Services and Supports (LTSS) to provide case management. The role participates in case conferences with the Supervisor and spends about 50% of working time visiting members in their homes or long-term care facilities. It serves members in Mesa County, Colorado, and surrounding areas; the employee must reside locally to Mesa County. The position offers remote work flexibility, but requires substantial travel within the assigned territory and reliable, independent transportation at the employee’s expense. The Case Manager coordinates the member’s case management process, including intake, screening, referral, assessment and reassessment, support-plan development, ongoing monitoring, documentation, resource development, and case closure. The role monitors member health and welfare, service delivery, and supports identified in the Support Plan and Prior Authorization Request. Contacts and assessments must meet the relevant LTSS program’s prescribed schedules and be updated when a member’s condition or services change. The position requires protecting confidential patient information and completing work accurately, on time, and in accordance with the CMA Contract Agreement. The Case Manager attends department and agency training and may assist with special assignments and system assessment or development. Suspected mistreatment, abuse, neglect, exploitation, or harmful acts must be referred immediately to the appropriate county protective services section and/or local law enforcement. This is a full-time position with an hourly pay range of $29.00 to $52.00, based on factors including local labor markets, education, work experience, and certifications. Benefits are subject to eligibility requirements.

Requirements

Bachelor’s degree in a human behavioral science field such as human services, social work, psychology, or public health; or 5+ years of relevant LTSS experience; or a combination of education and experience.
At least 1 year of experience with MS Office, including Word, Excel, and Outlook.
Reliable transportation and ability to travel up to 50% within the assigned territory to meet members and providers.
Residence local to Mesa County, Colorado.
Driver’s license and access to reliable transportation.
Independent, reliable, flexible, on-demand transportation at the employee’s expense for travel between locations.
If driving to meet the transportation requirement, meet Colorado licensure requirements and company liability insurance requirements.
Ability to maintain confidential patient information.

Nice To Haves

Experience as a caseworker or case manager serving the LTSS population in a private or public social services agency; this experience may substitute for required education on a year-for-year basis.

Responsibilities

Perform intake, screening, referral, assessment and reassessment, support-plan development, ongoing case management, member health and welfare monitoring, documentation, resource development, and case closure.
Participate in case conferences with the Supervisor.
Conduct monitoring contacts at least once each quarterly period, or more frequently when warranted by the member’s condition or program rules.
Conduct face-to-face member contact at least every six months, or more frequently when warranted; update the approved assessment tool and care or support plan to reflect changes in condition or services.
Complete a new assessment during an annual face-to-face reassessment, more frequently when warranted or required, and complete additional assessments as needed or required.
Monitor delivery of services and supports identified in the Support Plan and Prior Authorization Request (PAR).
Maintain confidentiality of patient information in accordance with company requirements.
Attend department-provided training for CMA agencies and agency in-service and staff development training.
Perform work accurately, promptly, and completely in accordance with the CMA Contract Agreement.
Immediately refer suspected mistreatment, abuse, neglect, exploitation, or harmful acts to the appropriate county department of social services protective services section and/or local law enforcement agency.
Undertake special assignments and projects as needed and assist with system assessment and development.
Travel within the assigned territory to visit members and providers, using reliable transportation and arriving and departing on time.