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- Miami, FL 33101
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Case Manager LTSS (HBCS) - Miami, FL - Plantation, FL 131043
Anthem, Inc. • Miami, FL
Posted 6 days ago
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Your Talent. Our Vision. At Amerigroup, a proud member of the Anthem, Inc. family of companies focused on serving Medicaid, Medicare and uninsured individuals, it’s a powerful combination. It’s the foundation upon which we’re creating greater care for our members, greater value for our customers and greater health for our communities. Join us and together we will drive the future of health care.
This is an exceptional opportunity to do innovative work that means more to you and those we serve.
Location: Work-At-Home Opportunity - Willing to service Miami-Dade County
Bilingual - English/Spanish is required
Case Manager / LTSS Service Coordinator-HBCS
Responsible for overall management of member's individual service plan within the scope of position, as required by applicable state law and contract; develops, monitors, and revises the member's service plan to meet the member's needs, with the goal of optimizing member health care across the care continuum. Responsible for performing telephonic or face-to-face non-clinical assessments using a tool with pre-defined response options for the identification, evaluation, coordination and management of member's needs, non-clinical long term service and support needs.
- Identifies members with potential for high risk complications and refers those members' cases to the clinical healthcare management team.
- Manages non-clinical needs of members with chronic illnesses, co-morbidities, and/or disabilities, to insure cost effective and efficient utilization of long term services and supports.
- Obtains a thorough and accurate member history to develop an individual service plan.
- Establishes short and long term service and support goals in collaboration with the member, caregivers, family, natural supports, physicians.
- Identifies members that would benefit from alternative level of care or other waiver programs.
- May also serve as mentor or preceptor for new staff, assisting in the formal training of associates and may be involved in process improvement initiatives.
- BA/BS in a health related; 2 years of experience working with a social work agency; or any combination of education and experience, which would provide an equivalent background.
- Travel required.
- Experience with Microsoft Office Suite strongly preferred
- CPR Certification strongly preferred.
- Previous LTSS experience strongly preferred.
- Bilingual English/Spanish required.
Anthem, Inc. is ranked as one of America’s Most Admired Companies among health insurers by Fortune magazine and is a 2014 DiversityInc magazine Top 50 Company for Diversity. To learn more about our company and apply, please visit us at antheminc.com/careers. EOE. M/F/Disability/Veteran.