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 complex healthcare, social service, and custodial needs. Focus on conducting in-home and nursing facility assessments, developing individualized care plans, and facilitating transitions between care settings.

Location: Must be based in Delaware (Kent and New Castle County) with reliable transportation for frequent travel to members' homes and nursing facilities.

Company

hirify.global is a large integrated healthcare organization providing health insurance and care delivery services.

What you will do

• Conduct regular face-to-face needs assessments through in-home and nursing facility visits.
• Develop and implement individualized care plans for members with chronic and complex health, social, and custodial needs.
• Coordinate LTSS, Medicaid, and DSNP benefits to ensure the safest and most cost-effective care.
• Facilitate member transitions between hospitals, nursing facilities, and community-based settings.
• Collaborate with integrated care teams, including behavioral health providers and discharge planners.
• Maintain detailed documentation of all case management interventions in electronic health records.

Requirements

• Must be based in Delaware (Kent and New Castle County) with reliable daily transportation.
• Bachelor's degree in Social Work or Health/Human/Education services with 3+ years of experience in long-term care, home health, or hospice.
• Alternatively, a Master's degree in the same fields with 1+ year of experience.
• Alternatively, current State RN or LPN licensure (or eNLC) with 2+ years of experience in long-term care or home health.
• Alternatively, a high school degree with 3 years of qualifying case management experience for aged, disabled, or HIV/AIDS populations.
• Dedicated home workspace used only for business purposes to comply with telecommuter policies.

Nice to have

• Certified Case Manager (CCM) certification.
• Licensed Social Worker certification (LBSW, LMSW, or LCSW).
• Experience working with HIV/AIDS, behavioral health, or developmental disabilities populations.
• Prior experience with Managed Care, Medicare, and Medicaid.

Culture & Benefits

• Hybrid work model combining work-from-home flexibility with community-based field visits.
• Opportunity to work within an integrated care team focusing on the least restrictive care environments.
• Collaborative environment focused on patient advocacy and optimal care outcomes.