LTSS Care Manager
Company: Centene Corporation
Location: Greensboro
Posted on: April 24, 2024
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Job Description:
You could be the one who changes everything for our 28 million
members as a clinical professional on our Medical Management/Health
Services team. Centene is a diversified, national organization
offering competitive benefits including a fresh perspective on
workplace flexibility. Qualified applicants must reside in one of
the following North Carolina cities: Greensboro, Fayetteville,
Wilmington, Goldsboro, Jacksonville/New Bern, Greenville, Rocky
Mount/Roanoke Rapids, Charlotte/Concord, Winston-Salem or Gastonia
Position Purpose: This licensed professional will be responsible
for the oversight and coordination of long term support
services/long term care for special (higher acuity) populations
residing in the community and/or skilled nursing facilities.
Examples include but are not limited to: individuals with 2 or
more, higher risk medical or behavioral health conditions (e.g.,
COPD and Schizophrenia). This position assumes a leadership role
with internal and external partners to achieve optimal health care
outcomes for the member through effective coordination of care
activities. Provides care coordination and care management and
oversees higher acuity long-term support services / long-term care
members. (i.e. individuals with complex medical or behavioral
health issues that place populations at greater risk for
potentially prevent able events such as avoidable admissions,
readmissions, and emergency room visits). Manages an active
caseload based on state mandated ratios according to residential
setting, case intensity and acuity. Partners effectively with the
PCP, Specialist, member, member's family and interdisciplinary care
teams (ICT) to develop a Person Centered Care Plan. Utilizes
clinical knowledge and expertise to craft strategies aimed at
member education to support self-management and achieve optimal
health outcomes. In partnership with the member, family,
physician(s), ICT and other providers, assesses short and long-term
member needs, evaluates the need for supportive e services and
establishes member driven care management objectives. Responsible
for coordination of service authorizations (i.e. meals,
transportation, activities of daily living). Performs clinical
interventions such as education on prescribed medication treatment
regimens and counseling. Ensures comprehensive assessments and
person-centered care plans are completed within required time
frames and utilizes clinical knowledge and expertise to assess
options for care including use of benefits and community resources.
Acts as liaison and member advocate between the member/family,
physician and facilities/agencies. Maintains accurate reports and
manages the integrity of care management activities in the
electronic care management system, using clinical guidelines.
Educates on and coordinates community resources, to include
medical, behavioral and social services. Applies care management
standards and maintains HIPAA standards and confidentiality of
protected health information. Ensures compliance with all state and
federal regulations and guidelines in day-to-day activities.
Participates in performance improvement activities. Performs
special projects as assigned. Additional Responsibilities: Performs
other duties as assigned Complies with all policies and standards
Education/Experience: Associates' degree in Nursing; Bachelor's
degree in social work, sociology, psychology, gerontology, or a
related social services field; Master's degree in social work,
sociology, psychology, gerontology, or a related social services
field Licenses and Certifications: A license in one of the
following is required (must be licensed in the state of practice):
Registered Nurse (RN) Licensed Practical Nurse (LPN) Licensed
Certified Social Worker (LCSW) Licensed Professional Counselor
(LPC) Licensed Medical Social Therapist (LMST) Licensed Mental
Health Counselor (LMHC) LTSS Care Manager requirements for North
Carolina: Two (2) years of LTSS and/or HCBS coordination, care
delivery monitoring, care management, social work, geriatrics,
gerontology, pediatrics, or human services required. RN or
LCSW/LCSW-A required. This is a hybrid position that offers the
flexibility of working from home along with up to 50% travel
conducting field work (in-home visits). Centene offers a
comprehensive benefits package including: competitive pay, health
insurance, 401K and stock purchase plans, tuition reimbursement,
paid time off plus holidays, and a flexible approach to work with
remote, hybrid, field or office work schedules. Actual pay will be
adjusted based on an individual's skills, experience, education,
and other job-related factors permitted by law. Total compensation
may also include additional forms of incentives. Centene is an
equal opportunity employer that is committed to diversity, and
values the ways in which we are different. All qualified applicants
will receive consideration for employment without regard to race,
color, religion, sex, sexual orientation, gender identity, national
origin, disability, veteran status, or other characteristic
protected by applicable law.
Keywords: Centene Corporation, Greensboro , LTSS Care Manager, Executive , Greensboro, North Carolina
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