LTSS Service Care Manager

Immediate need for a talented LTSS Service Care Manager. This is a 03+months contract to Hire opportunity with long-term potential and is located in Pinellas County Clearwater /Largo /Palm Harbor / South St. Pete (Remote). Please review the job description below and contact me ASAP if you are interested.

Job ID: 25-75001

Pay Range: $24 - $29/hour. Employee benefits include, but are not limited to, health insurance (medical, dental, vision), 401(k) plan, and paid sick leave (depending on work location).

Key Responsibilities:

• Monthly and quarterly member contact and will include 80% travel. Remote role. Will require a driver s license.
• Shift Time & Working Days: 8am-5pm Mon - Fri
• Assists in developing, assessing, and coordinating holistic care management activities to enable quality, cost-effective healthcare outcomes.
• May develop or assist with developing personalized service care plans/service plans for long-term care members and educates members and their families/caregivers on services and benefits available to meet member needs.
• Assists with developing ongoing long-term care plans/service plans and works to identify providers, specialist, and/or community resources needed for long-term care.
• Coordinates as appropriate between the member and/or family/caregivers and the care provider team to ensure identified services are accessible to members.
• Provides resource support to members and their families/caregivers for various needs (e.g. employment, housing, participant direction, independent living, justice, foster care) based on service assessment and plans.
• Monitors care plans/service plans, member status and outcomes, as appropriate, and provides recommendations to care plan/service plan based on identified member needs.
• Interacts with long-term care healthcare providers and partners as appropriate to ensure member needs are met.
• Collects, documents, and maintains long-term care member information and care management activities to ensure compliance with current state, federal, and third-party payer regulators.
• May perform home and/or other site visits to assess member s needs and collaborate with healthcare providers and partners.
• Provides and/or facilitates education to long-term care members and their families/caregivers on procedures, healthcare provider instructions, service options, referrals, and healthcare benefits.
• Provides feedback to leadership on opportunities to improve and enhance quality of care and service delivery for long-term care members in a cost-effective manner.
• Performs other duties as assigned, Complies with all policies and standards.
• Managing a case load for healthcare members with long term care needs.
• Geriatric long-term care. Member assessments and notes.
• Complete assessments with members, caregivers, or providers to obtain information regarding client status, support system, and need for services for care plan development.
• Monitor delivery of services and follow-up with members, caregivers, or provider s through in person visits and telephonic contact.
• Authorize and coordinate referral for services.
• Ensure provider services are delivered without gaps and identify functional deficiencies in plans of care.
• Assist in coordinating the development of informal or voluntary services to integrate into the member care plan Collaborate with discharge planners, physicians, and other parties to ensure appropriate discharge plan, care plan, and coordination of acute care and long-term care services!
• Assist member with filing and resolving complaints and appeals.
• Working with members in a face-to-face environment
• This position does have the intent to convert based on performance and eligibility
• Independent work
• Each member must be contacted once per month, and some may need to be seen

Key Requirements and Technology Experience:

• Key Skills; 2 years of field case management
• Technology Savy
• Must be able to look at calendar and manage time - ensuring enough time for documentation
• Education/Certification Required: Requires a Bachelor's degree and 2 4 years of related experience. (Bachelor s Degree should be within the realm of healthcare) Psychology, Sociology, etc.
• Field experience would need to be long term to have the team consider someone that does not have a degree within the space they are looking for.
• Licensure Required: Valid driver's license.
• 2+ years of Care Management experience (field experience is a must)
• Caseloads of 50,60,70 members bonus if it is geriatric
• Long Term Care Medicaid experience
• Medicaid / Medicare experience
• Need to see experience being able to manage high case load
• Fast paced environment regarding new processes and programs
• They must be comfortable being able to connect with IT should their equipment fail in the field, etc. or be able to go into an office location or IT space.
• All documentation must be within system within 24 hours of completion
• Experience with electronic medical health records
• Home Health Experience
• Discharge Planning
• Working with TruCare which is the software the team uses
• Disqualifiers:
• Not having field experience
• Not having previous experience with high caseloads
• Performance indicators: Bilingual always preferred req will indicate if Bilingual is required via the notes section.

Our client is a leading Healthcare Industry and we are currently interviewing to fill this and other similar contract positions. If you are interested in this position, please apply online for immediate consideration.

Pyramid Consulting, Inc. provides equal employment opportunities to all employees and applicants for employment and prohibits discrimination and harassment of any type without regard to race, color, religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state or local laws.

By applying to our jobs you agree to receive calls, AI-generated calls, text messages, or emails from Pyramid Consulting, Inc. and its affiliates, and contracted partners. Frequency varies for text messages. Message and data rates may apply. Carriers are not liable for delayed or undelivered messages. You can reply STOP to cancel and HELP for help. You can access our privacy policy .