LTSS Care Manager (5K sign on bonus)

Company: Carolina Complete Health
Location: Wilmington
Posted on: April 8, 2021

Job Description:

Transforming the health of our community, one person at a time.Were Carolina Complete Health, a subsidiary of Centene Corporation, and were on a mission to impact the health of our communities by making healthcare accessible to everyone. As a diversified, multi-national Fortune 50 and rapidly growing organization, our mission is fueled by exceptional talent. We need people driven to make a difference. People like you. People who could change everything for over 25 million people.Join our family today and take advantage of our generous benefits:* $5,000 sign-on bonus* Comprehensive insurance coverage* Tuition reimbursementAbout You:You are a highly collaborative, strategic risk-taker driven to make a difference and change the face of healthcare. You thrive in a supportive, result-oriented community and are committed to the relentless pursuit of continuous growth. Delivering patient-focused care while making a real impact is important to you it is what sets you apart!About Us:We are revolutionizing the world of healthcare through digital transformation and building world-class healthcare solutions. Our high caliber teams deliver relevant solutions at the local level and use collective innovation to turn visions into action and challenge what is possible.Centene is an industry leader with a local focus and a global vision:* Listed on Fortune magazines Worlds Most Admired Companies List for 2ndconsecutive year* National footprint across all 50 states, serving 1 in 15 individuals in the U.S.* Recognized as one of the Best Places to Work by the Human Rights Campaign FoundationAs a LTSS Care Manager you will: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, members 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.Additionally you will bring:* Associates degree in Nursing OR Bachelors degree in social work, sociology, psychology, gerontology, or a related social services field ORMasters degree in social work, sociology, psychology, gerontology, or a related social services field* Two (2) years of prior Long term support servicesand/or Home & community based servicecoordination, care delivery monitoring and care management experience;* Must reside in North CarolinaOne of the following licenses is required(must be licensed in the state of practice):* Registered Nurse (RN)* Licensed Certified Social Worker (LCSW)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.by Jobble

Keywords: Carolina Complete Health, Wilmington , LTSS Care Manager (5K sign on bonus), Executive , Wilmington, North Carolina