LTSS Service Care Manager

Centene Corporation

1d•$27 - $49•Hybrid

About The Position

You could be the one who changes everything for our 28 million members. Centene is transforming the health of our communities, one person at a time. As a diversified, national organization, you’ll have access to competitive benefits including a fresh perspective on workplace flexibility. Centene is seeking a LTSS Service Care Manager to join our Sunshine Health Long Term Services and Supports (LTSS) team. This is a hybrid role covering Pinellas County specifically Clearwater, Largo and Safety Harbor areas. This position is 75% field-based, with the opportunity to work remotely when not visiting members. Standard work hours are Monday – Friday, 8:00 AM – 5:00 PM (local time). Position Purpose: 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

Background in case management, healthcare, or social/community services
Strong ability to build relationships and support members in the community
Commitment to improving health outcomes and quality of life
Requires a Bachelor's degree and 2 – 4 years of related experience.
For Iowa Only: Bachelor's degree and 2+ years of experience with populations served; or RN with 6+ years of experience with population served.
Or equivalent experience acquired through accomplishments of applicable knowledge, duties, scope and skill reflective of the level of this position.

Responsibilities

Provide case management support for members in their homes or facilities
Collaborate with healthcare providers, social service agencies, and community resources
Ensure members receive high-quality, person-centered care
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.