Medicare Long Term Services & Support Care Coordinator

Responsibilities

• Deliver comprehensive care coordination for Medicare members receiving LTSS and custodial care.
• Conduct telephonic and in-person clinical assessments to evaluate members’ physical, behavioral, social, and long-term care needs.
• Identify high-risk members and collaborate with the Integrated Care Team to develop and implement individualized care plans.
• Coordinate services for members with chronic conditions, co-morbidities, and disabilities to promote efficient, cost-effective care.
• Gather detailed member histories and establish personalized care goals with members, caregivers, families, and providers.
• Facilitate access to appropriate services through referrals and authorizations, including home- and community-based programs.
• Collaborate with the Medical Director and care team to develop and monitor treatment plans.
• Address service issues and assist with provider or claims-related problem-solving.
• May oversee tasks assigned to other licensed or unlicensed professionals involved in member care coordination.
• Maintain up-to-date knowledge of CMS and Department of Health & Human Services (DHHS) regulations, licensure requirements, and internal policies.
• Promote a culture of teamwork, respect, diversity, and continuous improvement.

Education & Experience :

Licensure :

Skills & Abilities :

Our Comprehensive Benefits Package

Flexible work solutions include remote options, hybrid work schedules, competitive pay, paid time off, holidays, volunteer events, health insurance coverage for you and your dependents on Day 1, 401(k) tuition reimbursement, and more.