LTC Wellness Manager

Wellness Program Manager

This Wellness Program Manager is responsible for delivering and evolving proactive long-term care wellness programs designed to help policyholders live healthier, longer, and more independent lives. The role combines clinical assessment, member engagement, care navigation, and program operations to support aging in place, reduce risk, and improve outcomes across both pre-claim and emerging on-claim wellness offerings. This position applies strong clinical and functional judgment to assess member needs, identify appropriate interventions, and connect policyholders and caregivers with tailored services, resources, and vendors. The role also supports implementation of new wellness initiatives by partnering across operations, contact center, analytics, product, legal, and external vendors to ensure programs are operationally effective, scalable, and aligned with business goals.

Principal Duties and Responsibilities

• Engage policyholders and caregivers through outbound and follow-up calls to educate them on wellness programs, encourage participation, and support ongoing engagement.
• Conduct telephonic assessments using clinical and functional frameworks to identify risks, needs, and opportunities to support aging safely at home.
• Evaluate biological, cognitive, behavioral, environmental, and social factors affecting independence, health, and long-term care risk.
• Recommend wellness products, services, and interventions tailored to individual member needs and program eligibility.
• Support development of personalized care or wellness guidance designed to promote independence, reduce risk, and improve member experience.
• Review claims history, intake information, engagement signals, and other available data to identify members who may benefit from early intervention or additional support.
• Document interactions, recommendations, and follow-up activities accurately in workflow systems and case management tools.
• Collaborate with wellness vendors and external partners to coordinate services, resolve issues, identify care gaps, and improve the member experience.
• Partner with internal teamsincluding LTC operations, navigation, contact center, analytics, legal, marketing, and productto support implementation of wellness initiatives and ensure consistent member communication.
• Assist with rollout of new wellness programs by supporting training, scripting, process updates, and operational readiness across impacted teams.
• Monitor member engagement and follow through on referrals, recommendations, and service utilization to improve outcomes and inform future program enhancements.
• Help identify opportunities to improve wellness workflows, member journeys, assessment approaches, and program effectiveness.
• Provide education to policyholders and caregivers on aging resources, home safety, caregiver support, community-based services, and related wellness topics.
• Use motivational interviewing, empathy, and sound judgment to support members during sensitive or complex situations.
• Manage an individual work queue and contribute to team goals, pilot execution, and ongoing program development.
• May perform other duties as assigned.

Job Specifications

• Bachelor's Degree required
• Degree in Occupational Therapy, Social Work, Nursing, Gerontology, Case Management, Health Coaching, or another relevant clinical or health-related discipline; equivalent experience may be considered.
• Licensure or certification in a clinical discipline (such as OT, RN, LCSW, or CCM) preferred, but not required
• 5+ years of clinical experience or strong applied knowledge related to aging, chronic conditions, functional decline, caregiving, or care navigation.
• 5+ years of experience supporting older adults, caregivers, or individuals with complex health or functional needs in settings such as home health, care management, long-term care, rehabilitation, hospice, health plan support, or community-based services.
• Experience engaging individuals by phone, including education, outreach, enrollment support, care coordination, or motivational conversations.
• Excellent verbal and written communication skills, with the ability to explain programs clearly and build trust with members and caregivers.
• Strong organizational skills and ability to manage multiple priorities in a fast-paced, cross-functional environment.
• Ability to work independently while collaborating effectively across operational and strategic teams.
• Strong critical thinking and judgment, including the ability to escalate concerns and apply risk-aware decision making.
• Proficiency in Microsoft Office applications and ability to learn internal workflow, CRM, and case management systems.
• Familiarity with long-term care insurance, aging-in-place services, senior care resources, or wellness programming preferred.
• Experience working with external vendors or community-based partners preferred.
• Willingness to travel 5-10%