Case Manager Long-term Care - Delaware
Core
Single point of contact coordinating care needs for members enrolled in DSHP Plus LTSS and DSNP across home, nursing facility, and community-based settings.
Role type
Senior IC case manager (long-term care)
Builds
Individualized care plans and care transitions for members with chronic and complex health/social needs
Domain
Healthcare / Long-term care / Home and Community-Based Services (HCBS)
Required skills
Needs assessment, care plan development, care coordination, resource identification, care transition management, documentation, regulatory compliance (HIPAA), stakeholder collaboration
Preferred skills
Certified Case Manager (CCM), Licensed Social Worker (LBSW/LMSW/LCSW), behavioral health experience, developmental disabilities experience, HIV/AIDS population experience, Medicare/Medicaid experience
Technologies
Electronic health records, Word, Excel, Outlook
Responsibilities
Conduct in-home and nursing facility visits for needs assessments; Assess, plan, coordinate, implement, and evaluate care for members with chronic/complex needs; Authorize LTSS services and coordinate HCBS/Medicaid benefits; Facilitate transitions between care settings (hospital to home, facility to community); Educate members/caregivers on benefits and resources; Develop individualized care plans; Collaborate with healthcare teams and discharge planners; Document services in electronic health records; Ensure compliance with state/federal requirements.
Seniority
Mid-Senior level, hands-on IC