LTSS Service Care Manager

Centene Corporation•Olathe, KS

2d•Hybrid

About The Position

Assists in developing, assessing, and coordinating holistic care management activities to enable quality, cost-effective healthcare outcomes. May develop or assist with developing personalized service care plans/service plans for long-term care members and educates members and their families/caregivers on services and benefits available to meet member needs. 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 home and/or other site visits to assess member’s needs and collaborate with healthcare providers and partners. 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.

Requirements

Requires a Bachelor's degree and 2 – 4 years of related experience.
Or equivalent experience acquired through accomplishments of applicable knowledge, duties, scope and skill reflective of the level of this position.

Responsibilities

Develop, assess, and coordinate holistic care management activities.
Develop personalized service care plans/service plans for long-term care members.
Educate members and their families/caregivers on available services and benefits.
Evaluate member needs and available resources to facilitate the best outcome.
Identify providers, specialists, and community resources for long-term care.
Coordinate between members, families/caregivers, and care provider teams.
Provide resource support for various member needs (e.g., employment, housing, independent living).
Monitor care plans, member status, and outcomes, and provide recommendations.
Interact with long-term care healthcare providers and partners.
Collect, document, and maintain member information and care management activities.
Perform home and/or other site visits to assess member needs.
Provide and/or facilitate education to members and their families/caregivers.
Provide feedback to leadership on quality of care and service delivery improvements.
Perform other duties as assigned.
Comply with all policies and standards.