Case Manager DSHP Long Term Services & Support (New Castle County)

Location: Wilmington, DE

Primary Job Function: Medical Management

ID**: 37920

Job Brief

The Case Manager LTSS will support AmeriHealth Caritas Delaware LTSS participants in the New Castle county. Travel will be required.

Your career starts now. We are looking for the next generation of health care leaders.

At AmeriHealth Caritas, we are passionate about helping people get care, stay well and build healthy communities. As one of the nations leaders in health care solutions, we offer our associates the opportunity to impact the lives of millions of people through our national footprint of products, services and award-winning programs. AmeriHealth Caritas is seeking talented, passionate individuals to join our team. Together we can build healthier communities. If you want to make a difference, we would like to hear you.

Headquartered in Newtown Square, AmeriHealth Caritas is a mission-driven organization with more than 30 years of experience. We deliver comprehensive, outcomes-driven care to those who need it most. We offer integrated managed care products, pharmaceutical benefit management and specialty pharmacy services, behavioral health services, and other administrative services.

Discover more about us at www.amerihealthcaritas.com.

Responsibilities:

The Case Manager assists members who are eligible for LTSS in obtaining the services they need as required by DSHP Plus LTSS in New Castle county Delaware. He or she contributes to the LTSS case management process by performing telephonic and/or face-to-face assessments for the identification, evaluation, coordination and management of members needs, including physical health, behavioral health, social services and long term services and supports.

• Facilitate person centered planning team meetings to coordinate care and services. Identify, coordinate, and assist participants in gaining access to needed LTSS services and other Covered Services, as well as non-covered medical, social, housing, educational, and other services and supports.

• Provides information to participants and conducts monitoring of authorized services and supports for Participants.

• Informs participants about available LTSS required needs assessments, the care plan process, service alternatives and service delivery options.

• Informs participants of their rights and responsibilities as well as assists with the complaint, grievance, and DHS Fair Hearing process.

• Collects additional necessary information, including participant preferences, strengths, and goals to inform the development of the Plan of Care.

• Conducts comprehensive health needs assessments annually or more frequently as needed in accordance with requirements.

Education/Experience:

• Bachelor’s Degree in social work, psychology or other related fields.

• At least 3 years working in social service or health care related field.

• Experience working with people with disabilities or seniors in need of LTSS.

• Knowledge of the home and community-based service system and how to access and arrange for services.

• Experience conducting LTSS needs assessments and monitoring LTSS delivery.

• Cultural competency and the ability to provide informed advocacy.

• Ability to interact with health care professionals in a professional manner.

• Ability to travel up to 75%.

• Valid driver’s license required.

Diversity, Equity, and Inclusion

At AmeriHealth Caritas, everyone can feel valued, supported, and comfortable to be themselves. Our commitment to equity means that all associates have a fair opportunity to achieve their full potential. We put these principles into action every day by acting with integrity and respect. We stand together to speak out against injustice and to break down barriers to support a more inclusive and equitable workplace. Celebrating and embracing the diverse thoughts and perspectives that make up our workforce means our company is more vibrant, innovative, and better able to support the people and communities we serve.

We keep our associates happy so they can focus on keeping our members healthy.

Our Comprehensive Benefits Package

Flexible work solutions including remote options, hybrid work schedules, Competitive pay, Paid time off including holidays and volunteer events, Health insurance coverage for you and your dependents on Day 1, 401(k) Tuition reimbursement and more.

EOE Minorities/Females/Protected Veterans/Disabled