LTSS Care Manager
Company: Centene Corporation
Location: Greensboro
Posted on: April 24, 2024
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 fieldLicenses 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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