Case Manager Long-term Care - Delaware, New Castle County RN
Core
Deliver comprehensive case management services to DSHP Plus LTSS and DSNP members through home/site visits, care plan development, and service coordination.
Role type
Senior IC case manager (long-term care)
Builds
Individualized care plans and coordinated service delivery for members
Domain
Healthcare / Long-term care / Managed care
Required skills
Comprehensive member assessment, Individualized care plan management, Holistic service coordination, Member advocacy, Care transition management, Outcome evaluation, Cost & quality improvement, Regulatory adherence, Benefit maximization
Preferred skills
Certified Case Manager (CCM), Licensed Social Worker (LBSW/LMSW/LCSW), Home clinical experience, Behavioral health experience, Developmental disabilities experience, Medicare/Medicaid experience
Technologies
Case management software, Electronic health records (EHR), Microsoft Office suite
Responsibilities
Conduct in-person assessments of member health status and needs; Develop and monitor individualized care plans addressing physical, behavioral, and social needs; Coordinate access to community resources and specialists; Serve as primary advocate for members and caregivers; Ensure seamless care transitions between hospitals and community settings; Monitor member progress and adjust care plans to optimize outcomes; Identify opportunities for cost savings and quality improvement; Ensure strict compliance with regulatory requirements and company policies.
Seniority
Mid-level, hands-on IC