Ohana Health Plan
Apply for the
LTSS Service Care Manager
role at
Ohana Health Plan .
Position Purpose Assists in developing, assessing, and coordinating holistic care management activities to enable quality, cost-effective healthcare outcomes. May develop or assist with developing personalized service care plans for long‑term care members and educates members and their families/caregivers on services and benefits available to meet member needs.
Responsibilities
Evaluates the needs of the member, the resources available, and recommends and/or facilitates the plan for the best outcome
Assists with developing ongoing long‑term care plans and works to identify providers, specialists, and/or community resources needed for long‑term care
Coordinates as appropriate between the member and/or family/caregivers and the care provider team to ensure identified services are accessible to members
Provides resource support to members and their families/caregivers for various needs (e.g. employment, housing, participant direction, independent living, justice, foster care) based on service assessment and plans
Monitors care plans, member status and outcomes, as appropriate, and provides recommendations to care plan based on identified member needs
Interacts with long‑term care healthcare providers and partners as appropriate to ensure member needs are met
Collects, documents, and maintains long‑term care member information and care management activities to ensure compliance with current state, federal, and third‑party payer regulators
May perform home and/or other site visits to assess member’s needs and collaborate with healthcare providers and partners
Provides and/or facilitates education to long‑term care members and their families/caregivers on procedures, healthcare provider instructions, service options, referrals, and healthcare benefits
Provides feedback to leadership on opportunities to improve and enhance quality of care and service delivery for long‑term care members in a cost‑effective manner
Performs other duties as assigned
Complies with all policies and standards
Education & Experience Requires a Bachelor's degree and 2 – 4 years of related experience. Or equivalent experience acquired through accomplishments of applicable knowledge, duties, scope and skill reflective of the level of this position.
License / Certification
For Iowa: Bachelor's degree with 30 semester hours (or equivalent) in a human services field and at least two years of experience in the delivery of services to the population groups or current state’s Registered Nurse (RN) license and at least four years of experience required
For North Carolina Standard Plan: 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. RN or LCSW required.
For North Carolina Tailored Plan: 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. RN or LCSW/LCSW‑A preferred.
For Florida LTSS ECC: Must have 2 years of youth/young adult experience required.
For Hawaii: Current Hawaii Registered Nurse (RN) license required.
For Arkansas Total Care plan: This position is designated as safety sensitive and requires a driver’s license, child and adult maltreatment check (before hire and recurring), and a drug screen (at time of hire and recurring). Must reside in Arkansas or a border city. Travel 5% required.
Pay Range $26.50 – $47.59 per hour.
Benefits Centene offers a comprehensive benefits package including competitive pay, health insurance, 401(k) and stock purchase plans, tuition reimbursement, paid time off plus holidays, and a flexible approach to work with remote, hybrid, field or office work schedules. Total compensation may also include additional forms of incentives. Benefits may be subject to program eligibility.
EEO Statement 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. Qualified applicants with arrest or conviction records will be considered in accordance with the LA County Ordinance and the California Fair Chance Act.
Seniority Level
Not Applicable
Employment Type
Full‑time
Job Function
Health Care Provider
Industries
Hospitals and Health Care and Insurance
Referrals increase your chances of interviewing at Ohana Health Plan by 2×.
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LTSS Service Care Manager
role at
Ohana Health Plan .
Position Purpose Assists in developing, assessing, and coordinating holistic care management activities to enable quality, cost-effective healthcare outcomes. May develop or assist with developing personalized service care plans for long‑term care members and educates members and their families/caregivers on services and benefits available to meet member needs.
Responsibilities
Evaluates the needs of the member, the resources available, and recommends and/or facilitates the plan for the best outcome
Assists with developing ongoing long‑term care plans and works to identify providers, specialists, and/or community resources needed for long‑term care
Coordinates as appropriate between the member and/or family/caregivers and the care provider team to ensure identified services are accessible to members
Provides resource support to members and their families/caregivers for various needs (e.g. employment, housing, participant direction, independent living, justice, foster care) based on service assessment and plans
Monitors care plans, member status and outcomes, as appropriate, and provides recommendations to care plan based on identified member needs
Interacts with long‑term care healthcare providers and partners as appropriate to ensure member needs are met
Collects, documents, and maintains long‑term care member information and care management activities to ensure compliance with current state, federal, and third‑party payer regulators
May perform home and/or other site visits to assess member’s needs and collaborate with healthcare providers and partners
Provides and/or facilitates education to long‑term care members and their families/caregivers on procedures, healthcare provider instructions, service options, referrals, and healthcare benefits
Provides feedback to leadership on opportunities to improve and enhance quality of care and service delivery for long‑term care members in a cost‑effective manner
Performs other duties as assigned
Complies with all policies and standards
Education & Experience Requires a Bachelor's degree and 2 – 4 years of related experience. Or equivalent experience acquired through accomplishments of applicable knowledge, duties, scope and skill reflective of the level of this position.
License / Certification
For Iowa: Bachelor's degree with 30 semester hours (or equivalent) in a human services field and at least two years of experience in the delivery of services to the population groups or current state’s Registered Nurse (RN) license and at least four years of experience required
For North Carolina Standard Plan: 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. RN or LCSW required.
For North Carolina Tailored Plan: 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. RN or LCSW/LCSW‑A preferred.
For Florida LTSS ECC: Must have 2 years of youth/young adult experience required.
For Hawaii: Current Hawaii Registered Nurse (RN) license required.
For Arkansas Total Care plan: This position is designated as safety sensitive and requires a driver’s license, child and adult maltreatment check (before hire and recurring), and a drug screen (at time of hire and recurring). Must reside in Arkansas or a border city. Travel 5% required.
Pay Range $26.50 – $47.59 per hour.
Benefits Centene offers a comprehensive benefits package including competitive pay, health insurance, 401(k) and stock purchase plans, tuition reimbursement, paid time off plus holidays, and a flexible approach to work with remote, hybrid, field or office work schedules. Total compensation may also include additional forms of incentives. Benefits may be subject to program eligibility.
EEO Statement 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. Qualified applicants with arrest or conviction records will be considered in accordance with the LA County Ordinance and the California Fair Chance Act.
Seniority Level
Not Applicable
Employment Type
Full‑time
Job Function
Health Care Provider
Industries
Hospitals and Health Care and Insurance
Referrals increase your chances of interviewing at Ohana Health Plan by 2×.
#J-18808-Ljbffr