LTSS Service Care Manager
Job Description
You could be the one who changes everything for our 28 million members. Centene is transforming the health of our communities, one person at a time. As a diversified, national organization, you’ll have access to competitive benefits including a fresh perspective on workplace flexibility.
Texas STAR Plus Clinical & Care Management Team
Behavioral Health – LVN or Social Worker
Must reside in Abilene, Blackwell, San Angelo, Ballinger, Coleman, Miles, or Sonora, TX
Hybrid: Work from home and travel to conduct member home visits
Monday – Friday – 8 am – 5 pm (CST)
Position Purpose: 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.
• Evaluates the needs of the member, the resources available, and recommends and/or facilitates the plan for the best outcome
• 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
Education/Experience: Requires a bachelor’s or master’s degree and 2 – 4 years of related experience or equivalent experience acquired through accomplishments of applicable knowledge, duties, scope and skill reflective of the level of this position.
Preferred Experience:
• 3+ years of case management experience working directly with adults with Behavioral Health and or IDD conditions
• 2+ years of experience coordinating medical and psychosocial services, and providing patient advocacy and education to Medicaid members
• Experience administering health assessments and managing high caseloads
• Experience in field-based roles in home health, hospital, community health, social services, or counseling/therapy settings.
• Role requires strong adaptability, flexibility, and resiliency skills.
• Proficient computer skills and experience working within large databases or provider information systems and Microsoft Office applications.
• Experience working in managed care environment is a PLUS (Federal and State Sponsored Govt Programs), but not required
Pay Range: $26.50 – $47.59 per hour