Clinical - LTSS Service Care Manager

Location: Contractors will work from home but will be visiting members in facilities or their homes. 80% is member facing. Seeking candidates who reside in Lake Worth, Delray Beach or Boca Raton area who speaks Spanish.

SHIFT: 8-5 Mon-Fri Day to Day Responsibilities of this Position and Description of Project:

• Managing a case load for healthcare members with long term care needs.
• Monthly and quarterly member contact and will include 80% travel. Remote role. Will require a drivers license.
• 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

Bachelors degree or Registered Nurse License and 2+ years of care management experience, Licensed Practical Nurse and 4+ years of care management experience, or 6+ years of care management experience. Home health, discharge planning, or long term care experience preferred. Licenses/Certifications: Valid driver's license Internal/External Groups with which the Candidate will interface: Required Skills/Experience: Preferred Skills/ Experience: 1. 2+ years of Care Management experience 1. Home health 2. Experience with electronic medical health records 2. Long term care 3. Microsoft office 3. Discharge planning 4. 4. Bilingual in Spanish Education Requirement: Bachelors Degree Education Preferred: