Case Manager Long-term Care (Delaware)

TL;DR

Case Manager Long-term Care (Delaware): Coordinate members’ care needs across service delivery systems and community supports with an accent on in-home and nursing facility assessments, LTSS authorization, and integrated care transitions. Focus on building individualized care plans, coordinating HCBS/Medicaid/DSNP services, and documenting interventions in the electronic health record while meeting state and federal compliance requirements.

Company

hirify.global provides healthcare-related services and programs for members.

What you will do

• Conduct regular face-to-face needs assessments in members’ homes and nursing facilities, with follow-up telephonic contact per guidelines.
• Assess, plan, coordinate, implement, and evaluate care for members with chronic and complex health, social, and custodial needs.
• Authorize LTSS services after comprehensive needs assessments and coordinate HCBS services, Medicaid, and DSNP benefits.
• Facilitate safe, least-restrictive care transitions across home, community, and community-based care settings (e.g., hospital-to-home, nursing facility-to-community).
• Develop individualized care plans with members/caregivers, including backup plans for gaps in provider coverage.
• Document all case management services and interventions in the electronic health record and follow HIPAA/privacy and quality standards.

Requirements

• Location: Must work within the assigned territory in Delaware (DE) and travel 25%–50% within the territory.
• Bachelor’s degree in Social Work or related field with 3 years of experience in long-term care/home health/hospice/public health/assisted living, or Master’s degree with 1 year of experience, or current State RN/LPN licensure (or eNLC multi-state licensure) with 2 years of experience, or high school degree with 3 years of qualifying case management experience for aged/behavioral health/disability/HIV/AIDS populations.
• Ability to work flexible hours to meet members’ needs and meet regulatory deadlines.
• Proficiency with PC-based documentation tools (Word, Excel, Internet, Outlook) and experience with electronic documentation systems.
• Reliable daily transportation to travel within the assigned territory.
• Compliance with HIPAA and privacy practices.

Culture & Benefits

• Works from home with a dedicated home workspace used only for business purposes.
• Frequent travel within the assigned Delaware territory and direct work with members in home and nursing facility settings.
• Adheres to privacy and security requirements, including HIPAA, and company/state/federal compliance standards.
• Base pay determined by qualifications, experience, and internal equity; displayed range may vary by location.