LTSS Service Care Manager - J01031

LTSS Service Care Manager – RN / LCSW

Location:

Remote – North Carolina

Primary Service Area:
Pitt County, NC and surrounding region

Schedule:

Monday–Friday, 8:00 AM–5:00 PM EST

Pay Rate:$40.00 per hour

Contract:

6 months, with potential to extend or convert

Travel:
Approximately 80% for face-to‑face member visits

Openings: 2

We are seeking an experienced LTSS Service Care Manager to support members with Long-Term Support Services (LTSS) needs throughout North Carolina. This is a remote, field-based case management position. Administrative responsibilities are completed remotely, while the majority of the role involves traveling throughout the assigned service area to conduct face-to‑face member visits. The Service Care Manager will manage an assigned caseload, conduct comprehensive assessments, develop and monitor individualized care plans, coordinate healthcare and long-term services, and collaborate with members, caregivers, physicians, providers, discharge planners, and other members of the healthcare team.

• Manage a caseload of members with Long-Term Support Services (LTSS) needs.
• Conduct comprehensive assessments with members, caregivers, and providers to evaluate medical status, functional needs, support systems, and required services.
• Develop and assist with individualized service and care plans.
• Conduct required monthly and quarterly member contacts.
• Complete face-to‑face member visits in homes and community settings.
• Monitor delivery of authorized services and follow up to ensure continuity of care.
• Identify gaps in services and coordinate appropriate solutions.
• Follow up with members, caregivers, and providers through in‑person and telephonic contact.
• Authorize and coordinate referrals and services based on member needs.
• Coordinate healthcare services with physicians, providers, discharge planners, and other healthcare professionals.
• Assist with discharge planning and transitions between acute care and long‑term services.
• Coordinate informal, voluntary, and community‑based services as appropriate.
• Support members and caregivers in understanding available healthcare services and benefits.
• Assist members with complaints and appeals.
• Maintain accurate assessments, care plans, case notes, and other required documentation.
• Utilize electronic medical records and case management systems.
• Participate in virtual team meetings, training, and care coordination activities.

• Bachelor's degree required.
• Current, active RN or LCSW/LCSW‑A license required.
• 2–4+ years of physical healthcare case management experience.
• Experience in one or more of the following areas:
  Hospital Case Management
• Physical Health Case Management
• Utilization Management
• Home Health
• Discharge Planning
• Care Management Experience conducting patient/member assessments.
• Experience developing and managing care plans.
• Experience coordinating healthcare services and providers.
• Valid driver's license required.
• Ability and willingness to travel extensively for face‑to‑face member visits.
• Strong Microsoft Office skills.
• Experience working with electronic medical records.
• Strong written and verbal communication skills.
• Ability to work independently while effectively managing a caseload.

• 4–6+ years of physical healthcare case management experience.
• LTSS or Long‑Term Care experience.
• Home health experience.
• Community health or member‑facing experience.
• Hospital discharge planning experience.
• Utilization management experience.
• Experience working with medically complex populations.
• Experience coordinating services across acute and long‑term care settings.
• Knowledge of healthcare resources and community‑based services.

This position requires approximately 80% travel for…