Job description

Job description

Title: LTSS Care Manager
Reports To: Care Team Manager

Department: LTSS Care Management Market: California

Independent Living Systems is committed to enhancing quality of life through innovative health and support solutions that reduce costs and foster independence. Central to the effectiveness of ILS-CAre Teams, the Care Manager (CM) is responsible to provide high quality LTSS Care Coordination to Health Plan Members on his/her caseload in a timely, effective and professional manner.

• Excellent interpersonal skills
• Excellent verbal and written communication skills
• Self-disciplined with excellent analytical and problem-solving skills
• Technological proficiency
• Ability to work well with others, including staff, clients, members and the public
• Conduct Face to Face Health Risk Assessments (HRA), to identify member’s LTSS needs in a timely, engaging and professional manner
• Develop Care Plans and interventions within the care manager scope of practice, including workflows, P&Ps and timelines
• Refer non-LTSS needs to KP Case Manager
• Refer member to appropriate LTSS resources: CBAS, IHSS, MSSP, community resources, and waiver programs. Facilitate access to LTSS resources as needed
• Provide service coordination in an effective and timely manner
• Document all services in eCARE utilizing the S.O.A.P. format
• Collaborate with KP CMs, providers, social workers, etc. in response to member needs
• Respond to direct referrals within prescribed timelines
• Engage family and other care givers – building and strengthening relationships
• Respond appropriately (as specified in workflows and policies and procedures) to

 DME needs
 safety issues
 emergency situations
 suspected abuse/neglect
 other critical situations

• Engage in effective transition of care from inpatient/SNF setting to home or different levels of care
• Ensure proper continuity of care when cases are transferred between CMs
• Maintain effective and timely communication with care assistants and other care team members
• Develop and make case presentations
• Foster relationships with KPCMs, community resource sources, and CBAS, MSSP, IHSS, and waiver program representatives
• Attend meetings, training sessions and conferences
• Complete administrative tasks – read/respond to emails, track mileage, maintain ADP, etc.
• Properly utilize technology and electronic systems
• Effectively manage caseload
• Provide medical interpretation (if certified)
• Maintain active license or certification

Position Qualifications
Education: Licensed Vocational Nurse (LVN), Registered Nurse (RN) or Master of Social Work degree (MSW) or Bachelor of Social Work (BSW).
Licensure/Certification: Current California LVN or RN license, BSW or MSW diploma or transcript.
Minimum Experience: One or more years’ experience in managed healthcare and/or clinical case management.
Knowledge: Competency utilizing care management technological platform and the Microsoft Office Platform required. Familiarity with the California Coordinated Care Initiative (CCI) and managed care environment (preferred).

Physical Demands
This position may require duties including lifting and carrying up to 40 pounds and sitting for prolonged periods of time. Good Visual and auditory acuity as well as good manual dexterity and the ability to be readily understood are essential. Must be able to work in a stressful environment.

Job Type: Full-time

License:

• RN (Required)

Job Types: Full-time, Contract

Pay: From $1.00 per month

Benefits:

• 401(k)
• 401(k) matching
• Dental insurance
• Health insurance
• Life insurance
• Paid time off
• Vision insurance

Schedule:

• Monday to Friday

Experience:

• Case management: 1 year (Preferred)

Work Location: On the road

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