Dec 05, 2019
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, Sr. : Oversees the care for long term support services / long term care populations and provides coordination of care services for lower acuity individuals living in the community or nursing facilities. Ensures a comprehensive assessment of member's care needs and status, interdisciplinary team approach, and education of members. Works closely with internal and external partners to achieve optimal health care outcomes for the member through effective coordination of care activities.
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- Required Masters degree in social work, sociology, psychology, gerontology, or other related social services field- Preferred Possess a minimum of four (4) 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 two (2) years 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 eight (8) years of relevant experience. If RN, 2 years of experience is required CPR Certified Licensed Behavioral Professional i.e. RN, LPN, LCSW, LMHC, LMFT, LPC, LMST 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. Equal Opportunity Employer #MSTR
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