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LTSS Service Care Manager

Work from home Full-time role Hiring

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 Apply Job!

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