LTSS Care Manager
Company: Illinois Health Plan
Location: Apple River
Posted on: January 27, 2023
You could be the one who changes everything for our 26 million
members as a clinical professional on our Medical Management/Health
Services team. Centene is a diversified, national organization
offering competitive benefits including a fresh perspective on
This position is a remote opportunity in the state of Illinois
Provides care coordination and care management and oversees higher
acuity long-term support services / long-term care members. (i.e.
individuals with complex medical or behavioral health issues that
place populations at greater risk for potentially prevent able
events such as avoidable admissions, readmissions, and emergency
Manages an active caseload based on state mandated ratios according
to residential setting, case intensity and acuity.
Partners effectively with the PCP, Specialist, member, member's
family and interdisciplinary care teams (ICT) to develop a Person
Centered Care Plan.
Utilizes clinical knowledge and expertise to craft strategies aimed
at member education to support self-management and achieve optimal
In partnership with the member, family, physician(s), ICT and other
providers, assesses short and long-term member needs, evaluates the
need for supportive e services and establishes member driven care
Responsible for coordination of service authorizations (i.e. meals,
transportation, activities of daily living).
Performs clinical interventions such as education on prescribed
medication treatment regimens and counseling.
Ensures comprehensive assessments and person-centered care plans
are completed within required time frames and utilizes clinical
knowledge and expertise to assess options for care including use of
benefits and community resources.
Acts as liaison and member advocate between the member/family,
physician and facilities/agencies.
Maintains accurate reports and manages the integrity of care
management activities in the electronic care management system,
using clinical guidelines.
Educates on and coordinates community resources, to include
medical, behavioral and social services. Applies care management
standards and maintains HIPAA standards and confidentiality of
protected health information.
Ensures compliance with all state and federal regulations and
guidelines in day-to-day activities.
Participates in performance improvement activities.
Performs special projects as assigned. Additional
This licensed professional will be responsible for the oversight
and coordination of long term support services / long term care for
special (higher acuity) populations residing in the community
and/or skilled nursing facilities. Examples include but are not
limited to: individuals with 2 or more, higher risk medical or
behavioral health conditions (e.g., COPD and Schizophrenia). This
position assumes a leadership role with internal and external
partners to achieve optimal health care outcomes for the member
through effective coordination of care activities.
Candidate Education: Associates' degree in Nursing;
Bachelor's degree in social work, sociology, psychology,
gerontology, or a related social services field;
Master's degree in social work, sociology, psychology, gerontology,
or a related social services field
Possess a minimum of two (2) years of relevant experience and be a
Registered Nurse (RN), Licensed Certified Social Worker (LCSW),
Licensed Medical Social Therapist (LMST), Licensed Mental Health
Counselor (LMHC) and licensed to practice in the State or,
Possess a minimum of four (4) years of relevant experience and be a
licensed professional able to practice in the State. Licenses and
Certifications: A license in one of the following is required:
Required Other CPR Certified
Required Other One of the following licenses is required (must be
licensed in the state of practice):
Registered Nurse (RN)
Licensed Practical Nurse (LPN)
Licensed Certified Social Worker (LCSW)
Licensed Professional Counselor (LPC)
Licensed Medical Social Therapist (LMST)
Licensed Mental Health Counselor (LMHC)
Required Other For NC, LTSS CM applicants must meet the following
Two (2) years of prior LTSS and/or HCBS coordination, care delivery
monitoring and care management experience;
Prior experience with social work, geriatrics, gerontology,
pediatrics, or human services.
Our Comprehensive Benefits Package: Flexible work solutions
including remote options, hybrid work schedules and dress
flexibility, Competitive pay, Paid time off including holidays,
Health insurance coverage for you and your dependents, 401(k) and
stock purchase plans, Tuition reimbursement and best-in-class
training and development.
Centene is an equal opportunity employer that is committed to
diversity, and values the ways in which we are different. All
qualified applicants will receive consideration for employment
without regard to race, color, religion, sex, sexual orientation,
gender identity, national origin, disability, veteran status, or
other characteristic protected by applicable law.
Keywords: Illinois Health Plan, Rockford , LTSS Care Manager, Executive , Apple River, Illinois
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