- 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.
- Performs other duties as assigned
- Complies with all policies and standards
-
Care Manager
1 week ago
WellSense Health Plan Manchester, United StatesIt's an exciting time to join the WellSense Health Plan, a growing regional health insurance company with a 25-year history of providing health insurance that works for our members, no matter their circumstances. · The Clinical Care Manager will perform as a Lead Care Manager res ...
-
Care Manager
1 week ago
Emerson Hospital Concord, United States Per DiemJob Summary · As a member of the healthcare team, the RN care manager: · • Ensures that care provided by the healthcare team is given in an efficient and cost-effective manner while promoting optimal patient · outcomes. · • Assists the physician and healthcare team in promoting c ...
-
Home Care Manager
1 week ago
Granite VNA Concord, United StatesMonday - Friday 8:00 a.m. - 4:30 p.m. · Reporting to the VP of Home Care, the Home Care Manager is responsible for clinical business operations and patient care services of the agency's Home Care Services which includes planning, organizing, developing and managing the agency's H ...
-
RN Care Manager
3 weeks ago
Atrium Health Concord, United States Part timeOverview · Atrium Health Cabarrus is a regional 457-bed, not-for-profit hospital in Concord, NC. More than 4,200 hospital employees provide services through an extensive inpatient and outpatient network, including Jeff Gordon Children's Center, Hayes Family Center and Batte Canc ...
-
Home Care Manager
1 week ago
Concord Regional Visiting Nurse Association Concord, United StatesReasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. Home Care Manager is responsible for oversight of the daily operations in the Electronic Medical Record (EMR). The Home Care Manager may Care Manager, Manager, Occupa ...
-
Home Care Manager
1 week ago
Granite VNA, Inc. Concord, United StatesJob Type Full-timeDescriptionMonday - Friday 8:00 a.m. - 4:30 p.m.Reporting to the VP of Home Care, the Home Care Manager is responsible for clinical business operations and patient care services of the agency's Home Care Services which includes planning, organizing, developing a ...
-
Home Care Manager
1 week ago
Granite VNA Concord, United StatesMonday - Friday 8:00 a.m. - 4:30 p.m. · Reporting to the VP of Home Care, the Home Care Manager is responsible for clinical business operations and patient care services of the agencys Home Care Services which includes planning, organizing, developing and managing the agencys Ho ...
-
RN Care Manager
2 weeks ago
Atrium Health Concord, United States Full timeOverview · Atrium Health Carolinas Medical Center (CMC) is the flagship hospital of Atrium Health, which is distinguished throughout the Southeastern United States for its excellent patient care and medical expertise. · CMC operates at 2 locations: CMC and Atrium Health Mercy. T ...
-
Mds/managed Care Documentation Specialist
2 days ago
The Courville at Nashua Nashua, United States**Growth Opportunity** · **The Courville at Nashua **is a Senior Healthcare Community in Nashua, NH. We are locally owned and operated and committed to providing personalized service and care. We're looking for **Full-time MDS/Managed Care Documentation Specialist (RN preferred) ...
-
Health Care Administrative Manager
1 week ago
findajob.dwp Romford, United States permanentThe Company · ATS Medics Ltd specializes in providing essential support to GP surgeries and polyclinics by offering temporary and short-term cover solutions through our team of experienced general practitioners (GPs). Our mission is to ensure continuity of care and seamless opera ...
-
Registered Nurse
7 hours ago
BAYADA Home Health Care Concord, United States Full timeBAYADA Home Health is looking for a compassionate and dedicated Registered Nurse (RN) to join our team This office services our adult and geriatric clients on a per visit basis in territories throughout Stanly and Cabarrus counties. · We are currently hiring for per-diem/part ti ...
-
Dental Hygienist
5 days ago
Aspen Dental Concord, United States Full timeAt Aspen Dental, we put You 1st with world-class development plus industry-leading pay. Join our team today as a Dental Hygienist · Job Types: Full-time · Salary: · $83,000 - $104,000 per year (annualized base salary + incentive earnings, based on full time schedule) · Location-S ...
-
Primary Care Physician
1 week ago
One Medical Concord, United States Full timeAbout Us · One Medical is a primary care solution challenging the industry status quo by making quality care more affordable, accessible and enjoyable. But this isn't your average doctor's office. We're on a mission to transform healthcare, which means improving the experience fo ...
-
Staffing Coordinator
1 day ago
Carlton Senior Living Concord, United StatesGreat Place to Work Certified · **#BestWorkplaces**: · **#GPTWCertified**: · At Carlton, we are dedicated to enriching the lives of older adults by offering personalized care and fostering a warm and supportive environment. We know it takes a special group of individuals to help ...
-
Dental Hygienist
1 week ago
Aspen Dental Concord, United States Full timeAt Aspen Dental, we put You First with world-class development plus industry-leading pay. Join our team today as a Dental Hygienist · Job Types: Full-time, Part-time · Salary: · $93,600 - $104,000 per year (annualized base salary + incentive earnings, based on full time schedule) ...
-
Hospice Rn Case Manager
1 week ago
Anchor Health Concord, United States Full time· **ELIGIBLE FOR SIGN-ON BONUS** · Are you looking for a work place where you can make a genuine difference? · Company Culture that feels supportive, genuine and appreciative of all? · Anchor Health is committed to the communities of which we serve, the patients and families we ...
-
Registered Dietitian-Part time
1 day ago
Fresenius Medical Care Concord, United States Part timePURPOSE AND SCOPE:Provides nutritional services for the facility's in-center and home patients as applicable in order to maximize the patient's nutritional status and improve clinical outcomes. Functions as a member of the interdisciplinary healthcare team, supporting the FMCNA c ...
-
Observation Service
8 hours ago
Concord Hospital Concord, United States Full timeThe Observation Service (3 South) consists of two units working in tandem to provide care to ED and Medical Observation patients. Observation Service is a fast pace environment with a quick turnover of the patient population. The dedicated team includes providers, nurses, Departm ...
-
Interim HealthCare - New Hampshire Concord, United States**Registered Nurse Home Care** · **Concord NH** · $44.50 per Hour · Are you a dedicated and compassionate Registered Nurse (RN) looking for a deeply rewarding opportunity to make a difference in the life of a precious little one? Interim HealthCare is currently seeking an excepti ...
-
Front Desk Coordinator
2 days ago
The Joint Chiropractic Concord, United States**The Opportunity**: · At The Joint, our mission is to improve the quality of life through routine and affordable Chiropractic care. We are positively changing Chiropractic care nationwide. The Joint is the largest provider of non-insurance, self-pay Chiropractic health care in t ...
LTSS Care Manager - Concord, United States - Carolina Complete Health
1 week ago
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 or Winston-Salem
Position Purpose:
This 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.
Additional Responsibilities:
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)
For North Carolina Standard Plan: 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 required.
For North Caroline Tailored Plan: 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 preferred
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.