Case Manager Long-term Care (Medical)

TL;DR

Case Manager Long-term Care (Medical): Coordinating care needs for members across various service delivery systems and community supports with an accent on in-home assessments and nursing facility coordination. Focus on developing individualized care plans, facilitating transitions between care settings, and ensuring access to cost-effective community resources.

Location: Must be based in Delaware (DE) as the role requires frequent travel to members' homes and nursing facilities within the assigned territory.

Company

hirify.global is a leading healthcare provider and insurer dedicated to coordinating comprehensive care for its members.

What you will do

• Conduct regular in-home and nursing facility visits to perform face-to-face needs assessments.
• Assess, plan, and evaluate care for eligible members with chronic, complex health, or custodial needs.
• Authorize LTSS services and coordinate Medicaid and DSNP benefits.
• Facilitate transitions between care settings, such as hospital to home or nursing facility to community.
• Develop and implement individualized care plans in conjunction with members and caregivers.
• Document all case management services in electronic health records adhering to HIPAA and quality standards.

Requirements

• Bachelor's degree in Social Work or health/human services with 3 years of experience OR Master's degree with 1 year of experience.
• Alternatively, Current State RN or LPN licensure with 2 years of experience in long-term care.
• Alternatively, High school degree with 3 years of qualifying case management experience for aged or disabled populations.
• Reliable transportation for daily travel within the assigned Delaware territory.
• Proficiency in PC-based documentation (Word, Excel) and ability to meet regulatory deadlines.
• Must have a dedicated home work space for business purposes to comply with telecommuter policies.

Nice to have

• Certified Case Manager (CCM) or licensure (LBSW, LMSW, LCSW).
• Experience working with HIV/AIDS, behavioral health, or developmental disabilities populations.
• Knowledge of Medicare, Medicaid, and Managed care systems.

Culture & Benefits

• Flexible working hours to accommodate member needs.
• Hybrid work arrangement with a combination of home-based administration and field visits.
• Professional environment adhering to high ethical and legal standards of business conduct.
• Opportunity to impact member health and safety within a community-based setting.