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Long-Term Services and Supports Case Coordinator

2 months ago

Brownsville, Texas, United States DirectEmployers Full time

JOB DESCRIPTION

Position Overview


DirectEmployers is seeking a dedicated Case Manager to join our team, focusing on Long-Term Services and Supports (LTSS). In this role, you will collaborate with members, healthcare providers, and interdisciplinary teams to evaluate, facilitate, and coordinate comprehensive care tailored to individuals with significant needs.

Your primary responsibility will be to ensure that members receive high-quality, medically appropriate, and cost-effective care throughout their healthcare journey.


KEY RESPONSIBILITIES
1. Conduct thorough face-to-face assessments of members within regulated timelines.

2. Manage the enrollment and disenrollment processes for comprehensive waiver services.

3. Develop and execute individualized case management plans in partnership with members, caregivers, and healthcare professionals to meet specific needs and objectives.

4. Continuously monitor care plans to assess their effectiveness, document interventions, and recommend necessary adjustments.

5. Facilitate the integration of services, including behavioral health and long-term supports, to ensure seamless care continuity for members.

6. Evaluate medical necessity and authorize appropriate waiver services.

7. Provide guidance on covered benefits and funding sources.

8. Conduct in-person visits as required.

9. Organize interdisciplinary care team meetings to discuss service approvals or denials and foster informal collaboration.

10. Utilize motivational interviewing techniques to educate and empower members during interactions.

11. Identify barriers to care and offer support to address psychosocial, financial, and medical challenges.

12. Recognize critical incidents and formulate prevention strategies to safeguard member health and well-being.

13. Offer consultation and educational support to non-RN case managers.

14. Manage cases involving members with complex medical conditions and medication regimens.

15. Perform medication reconciliation as necessary.

Travel requirements for this position range from 50-75%.

QUALIFICATIONS

Education
Must be a graduate from an accredited nursing program.

Experience
Minimum of 1 year of experience working with individuals with disabilities or chronic conditions, specifically in Long-Term Services & Supports.

1-3 years of experience in case management, disease management, or healthcare settings is preferred.

Licensure/Certification
Must hold an active, unrestricted State Registered Nursing license (RN) in good standing.

If fieldwork is required, a valid driver's license with a clean driving record is necessary, along with reliable transportation.


Preferred Qualifications
Education
Bachelor's Degree in Nursing is preferred.

Experience
3-5 years in case management or related fields is preferred, along with experience working with populations receiving waiver services.

Certification
Active and unrestricted Certified Case Manager (CCM) certification is preferred.

Note:
DirectEmployers is committed to providing a competitive benefits and compensation package. We are an Equal Opportunity Employer (EOE) M/F/D/V.

Compensation Range:
Hourly rate ranges from $23.76 to $51.49, based on experience and qualifications.