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    LTSS Care Manager - Greenville, United States - Spectraforce Technologies

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    Description

    LTSS care Manager

    03 months

    Greenville NC (50% Onsite)


    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


    Candidate Experience:
    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)


    Required Other For NC, LTSS CM applicants must meet the following requirements:
    Two (2) years of prior LTSS and/or HCBS coordination, care delivery monitoring and care management experience;

    Prior experience with social work, geriatrics, gerontology, pediatrics, or human services.

    RN or LCSW/LCSW-A required


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