Case Manager Long-term Care (Medical)

TL;DR

Case Manager Long-term Care (Medical): Coordinating care needs for members across service delivery systems and community supports with an accent on long-term services and supports (LTSS) and DSNP. Focus on conducting in-home and nursing facility assessments, developing individualized care plans, and facilitating safe transitions between care settings.

Location: Must be based in Delaware (DE); role requires frequent travel (25-50%) within the assigned territory for in-home and facility visits.

Company

hirify.global is a leading healthcare provider and insurer focused on coordinating complex care and improving member health outcomes.

What you will do

• Conduct regular in-home and nursing facility visits to complete face-to-face needs assessments.
• Assess, plan, and evaluate care for members with chronic, complex health, social, and custodial needs.
• Authorize and coordinate LTSS services, Medicaid, and DSNP benefits to ensure appropriate care in the community.
• Facilitate transitions between care settings (e.g., hospital to home) using an integrated care team.
• Develop and implement individualized care plans to help members achieve health goals in the least restrictive environment.
• Document all interventions in electronic health records while adhering to HIPAA and quality standards.

Requirements

• Must be based in Delaware and possess reliable daily transportation for territory travel.
• Bachelor's degree in Social Work or health/human services with 3 years of experience, OR a Master's degree with 1 year of experience in long-term care/home health.
• Alternatively, a current State RN/LPN license (or eNLC) with 2 years of experience in long-term care/home health.
• Alternatively, a high school degree with 3 years of qualifying case management experience with elderly, disabled, or HIV/AIDS populations.
• Must have a dedicated home workspace used exclusively for business purposes.

Nice to have

• Certified Case Manager (CCM) or licensed social worker (LBSW, LMSW, LCSW) credentials.
• Experience working with behavioral health, developmental disabilities, or HIV/AIDS populations.
• Experience with Medicare, Medicaid, and managed care.

Culture & Benefits

• Work-from-home flexibility for administrative and case management tasks.
• Direct community impact by working with members in their homes and nursing facilities.
• Environment committed to ethical and legal standards of business conduct.