Case Manager Long-term Care (Delaware)

Location: Remote from Delaware, United States; frequent travel within the assigned Delaware territory is required, including visits to members' homes, nursing facilities, and community-based settings. Travel requirement: 25%–50%.

Company

hirify.global provides health coverage and care services for members with complex and long-term support needs.

What you will do

• Serve as the primary contact for members enrolled in DSHP Plus LTSS and DSNP, coordinating medical, behavioral, social, and long-term support needs.
• Conduct in-home and nursing facility assessments, participate in care plan conferences, and provide follow-up by telephone.
• Develop, implement, and evaluate individualized care plans, including backup plans for gaps in provider coverage.
• Authorize LTSS services and coordinate HCBS, Medicaid, DSNP, behavioral health, disease management, and complex case management resources.
• Facilitate transitions between hospitals, homes, nursing facilities, and community settings in collaboration with integrated care teams.
• Document interventions in electronic health records and comply with HIPAA, state, federal, and quality requirements.

Requirements

• Bachelor's degree in social work, health, human, or education services plus 3 years of qualifying experience; or a master's degree plus 1 year of experience; or current RN/LPN licensure plus 2 years of experience; or a high school diploma plus 3 years of qualifying case management experience.
• Qualifying experience may include long-term care, home health, hospice, public health, assisted living, or case management for older adults and people with behavioral health, physical, developmental, or HIV/AIDS-related needs.
• Must be able to work from home in Delaware and travel regularly throughout the assigned territory.
• Reliable transportation, a dedicated home workspace, proficiency with Microsoft Office and electronic documentation systems, and the ability to meet regulatory deadlines are required.
• Knowledge of Medicare, Medicaid, managed care, geriatric special needs, behavioral health, home health, cultural competency, cost neutrality, and budgeting is required or relevant to the role.

Nice to have

• Certified Case Manager certification.
• LBSW, LMSW, or LCSW licensure.
• One year of in-home clinical or case management experience.
• Experience with HIV/AIDS, behavioral health, or developmental disabilities populations.

Culture & Benefits

• Work-from-home position with flexible hours to meet member needs.
• Regular community-based work across members' homes, nursing facilities, and other care settings.
• Work includes collaboration with healthcare providers, behavioral health professionals, integrated care teams, and discharge planners.
• Responsibilities require protecting confidential information and following HIPAA, privacy, security, and business conduct standards.