Senior LTSS Service Care Manager

Centene Corporation

1d•Hybrid

About The Position

Centene is seeking a Senior LTSS Service Care Manager to join their team. This role is crucial in transforming the health of communities by providing a diversified, national approach to healthcare. The position offers competitive benefits and a flexible work environment. The Senior LTSS Service Care Manager will be responsible for assessing, planning, implementing, and coordinating holistic care management activities to ensure quality, cost-effective healthcare outcomes for long-term care members. This includes developing personalized care plans, educating members and their families on available services, identifying and coordinating necessary resources, and monitoring care plan effectiveness. The role also involves collaborating with healthcare providers, performing site visits, maintaining member records, and providing education on healthcare benefits and procedures. Additionally, the Senior LTSS Service Care Manager will partner with the leadership team to enhance the quality of care and service delivery, potentially provide guidance and training to other team members, and assist with additional assignments as needed.

Requirements

Must Reside in Miami, Franklin, Osage, or Linn County, KS
Worked with the Frail Elderly Population
Willing to Travel / Field Work (75%)
Excellent Communicate and Customer Service
Proficient in Microsoft Applications
Long-Term Support Services Care / Case Management
Managed Care Environment
Telephonic and Face to Face Visits
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.

Responsibilities

Assesses, plans, implements, and coordinates holistic care management activities to enable quality, cost-effective healthcare outcomes.
May develop or assist with developing a personalized 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.
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.