Position Title : LTSS Service Care Manager

Work Location : Odessa/Andrews/Fort Stockton, Pecos/Monahans/Kermit, and Alpine TX

Assignment Duration : 6 months

Work Schedule : 8am-5pm M-F - overtime may be required at times

Work Arrangement : Remote, member facing

Position Summary : Evaluates the needs of the most complex and high risk members and recommends a plan of care for the best outcome

Background & Context :

Must meet Quality standards of assessments of 92% or above

Documentation must be completed for assessments within 3 BD turn around time

Required travel of 75%

Mileage reimbursement provided for member facing visits

Travel within the MRSA West Area 3 days a week, work remotely 2 days

Key Responsibilities :

LTSS service care manager will have 3 days of travel for visits seeing the members in their home and 2 days working remote for documentation of assessments as well as any follow up and tasks required to work

SC will be assessing the member for approval or denial of personal attendant services to assist with Activities of daily living by filling out a H2060 form in the field

LTSS Service CM will fill out a required assessment and all forms, document their assessments and submitting for authorization or denial of services within a 3Business day turnaround

Acts as liaison and member advocate between the member/family, physician, and facilities/agencies

Provides and/or facilitates education to long-term care members and their families/caregivers on topics such as preventive care, procedures, healthcare provider instructions, treatment options, referrals, prescribed medication treatment regimens, and healthcare benefits

Educates on and coordinates community resources, to include medical and social services

Provides coordination of service authorization to members and care managers for various services based on service assessment and plans (e.g., meals, employment, housing, foster care, transportation, activities for daily living)

Ensures appropriate referrals based on individual member needs and supports the identification of providers, specialists, and community resources

Ensures identified services are accessible to members

Maintains accurate documentation and supports the integrity of care management activities in the electronic care management system

Works to ensure compliance with clinical guidelines as well as current state and federal guidelines

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

Qualification & Experience :

Required: Bachelor's degree and 2 - 4 years of related experience or LVN and 2 - 4 years of related equivalent experience

Preferred: Prefer Social Work, LVN, Medical background that would require at least a bachelor's degree

Must haves: Working the aged, blind or disabled population 5+ years or more. Bilingual strongly preferred

Nice to haves: Social Service/ Social Work/ Care Management / Services Coordination Or equivalent experience acquired through accomplishments of applicable knowledge, duties, scope and skill reflective of the level of this position. Nursing/ LVN/ Medical/ Case Management Experience

Education/Certification Required: Bachelor's degree and 2 - 4 years of related experience or LVN and 2 - 4 years of related equivalent experience Preferred: Prefer Social Work, LVN, Medical background that would require at least a bachelor's degree.

Licensure Required: n/a Preferred: n/a

Years of experience required

Disqualifiers

Best vs. average

Performance indicators

Must haves: Working the aged , blind or disabled population 5+ years or more. Bilingual strongly preferred

Nice to haves: Social Service/ Social Work/ Care Management / Services Coordination Or equivalent experience acquired through accomplishments of applicable knowledge, duties, scope and skill reflective of the level of this position. Nursing/ LVN/ Medical/ Case Management Experience

Disqualifiers: n/a

Performance indicators: n/a

Best vs. average: see below skills

Top 3 must-have hard skills

Level of experience with each

Stack-ranked by importance

Candidate Review & Selection

1 Aged, Blind or Disabled Population experience

2 Bilingual

3 Microsoft Office experience (Outlook, Word, Excel, etc...)