LTSS Care Specialist - Morgan, Sangamon, Cass, Logan
Professional Diversity Network
Information Technology (IT)
Who we are:
Meridian, a WellCare Company, is part of a national network of passionate leaders, achievers, and innovators dedicated to making a difference in the lives of our members, our providers and in the healthcare industry.
We provide government-based health plans (Medicare, Medicaid, and the Health Insurance Marketplace) in Michigan, Illinois, Indiana, and Ohio. As a part of the WellCare Family of companies, we deliver healthcare excellence to millions of members nationwide.
Our associates work hard, play hard, and give back. Meridian associates enjoy an exceptional experience and culture including special events, company sports teams, potlucks, Bagel Fridays, and volunteer opportunities.
A Day in the Life of a LTSS Care Specialist:
This field based position coordinates care for Meridian members in the community. This position must work collaboratively with multidisciplinary care teams that may include the member’s PCP, specialists, social worker/behavioral health specialist and community resource contacts, while functioning with professional autonomy under the supervision of the Care Coordination leadership team. This position performs appropriate assessments, organizes, reviews and reports health and social information through member home visits. Individuals in this position demonstrate cultural sensitivity, effective communication and motivational interviewing skills.
Coordination and care management of members with lower utilization of home community services (i.e. members attending adult day care services or those who are stable on current medication / treatment regimens).
Manages an active caseload based on state mandated ratios according to residential setting, case intensity and acuity.
Ensures comprehensive assessments are completed within required time frames and utilizes knowledge and expertise to assess options for care including use of benefits and community resources.
Partners effectively with the PCP, Specialist, member, member’s family and integrated care teams (ICT) to develop a Person Centered Care Plan.
In partnership with the member, family, physician(s), ICT and other providers, assesses short and long term member needs, evaluates the need for alternative services and establishes member driven care management objectives.
Responsible for coordination of service authorizations (i.e. meals, transportation, activities of daily living).
Educates on and coordinates community resources with emphasis on medical, behavioral and social services. Applies care management standards and maintains HIPAA standards and confidentiality of protected health information.
Ensures compliance with all state and federal regulations and guidelines in day-to-day activities.
Performs special projects as assigned.
What you can bring to Meridian:
Bachelors degree in social work, sociology, psychology, gerontology, or other related social services field is Required
Masters degree in social work, sociology, psychology, gerontology, or other related social services field is preferred
Possess a minimum of two (2) years of relevant experience and have a Bachelor’s degree in social work, sociology, psychology, gerontology, or a related social services field; or Possess a master’s degree in social work, sociology, psychology, gerontology, or a related social services field may substitute experience obtained through a practicum, internship, or clinical rotation on an equivalent basis for up to one (1) year of the experience requirements; Non-degreed candidates may substitute professional human service experience on a year-for-year basis for the educational requirement with a minimum of six (6) years of relevant experience.
Demonstrated written communication skills
Demonstrated interpersonal/verbal communication skills
Knowledge of healthcare delivery
Ability to work as part of a team
Ability to work independently
Ability to work in a fast paced environment with changing priorities
Demonstrated organizational skills
What Meridian can offer you:
Our healthcare benefits include a variety of plans that are effective on the first day of employment for our new full-time team members.
Opportunity to work with the industry’s leading technologies and participate in unique projects, demonstrations, conferences, and exclusive learning opportunities.
Meridian offers 401k matching that is above the national average.
Full-time Meridian employees are eligible for tuition reimbursement towards Bachelor’s or Master’s degrees.
Meridian was named Detroit's #1 Fastest Growing Company by Crain's Magazine, so it is a great time to get involved with Meridian.