Clinical Ltss Care Navigator - San Antonio

Assists in developing, assessing, and coordinating holistic care management activities to enable quality, cost-effective healthcare outcomes. May develop or assist with developing personalized service care plans/service plans for long-term care members and educates members and their families/caregivers on services and benefits available to meet member needs.

Education/Experience: Requires a Bachelor's degree and 1 year of related experience.

Or equivalent experience acquired through accomplishments of applicable knowledge, duties, scope and skill reflective of the level of this position.

For Iowa Plan Only: A bachelor s degree with 30 semester hours or equivalent quarter hours in a human services field (including, but not limited to, psychology, social work, mental health counseling, marriage and family therapy, nursing, education, occupational therapy, and recreational therapy) and at least one year of experience in the delivery of services to the population groups that the person is hired as a case manager or case management supervisor to serve; or An Iowa license to practice as a registered nurse and at least three years of experience in the delivery of services to the population group the person is hired as a case manager or case management supervisor to serve .

For Illinois Plan Only: In addition to the requirements above the employee working on

Physically Disabled/Elderly

1. RN licensed in Illinois.
2. Bachelor or Master s Degree prepared in human services related field. Bachelor s degree in Human Services related field defined as: Child, Family and Community Services, Early Child Development, Guidance and Counseling, Home Economics- Child and Family Services, Human Development Counseling, Human Service Administration, Human Services, Master of Divinity, Pastoral Care, Pastoral Counseling, Psychiatric Nursing, Psychiatry, Psychology, Public Administration, Rehabilitation Counseling, Social Science, Social Services/Social Work or Sociology.
3. LPN with one (1) year experience in conducting comprehensive assessments and provision of formal service for the elderly

Brain Injury/HIV/AIDS

1. A Registered Nurse (RN) licensed in Illinois and a bachelor s degree in nursing, social work, social sciences or counseling or four (4) years of case management experience
2. Certified or Licensed social worker with Bachelor s degree in either social work, social sciences or counseling or a Masters of social work
3. Unlicensed social worker: minimum of bachelor s degree in social work, social sciences, or counseling

In addition to meeting one of the above criteria, must have experience working with: Addictive and dysfunctional family systems

• Evaluates the needs of the member, the resources available, and recommends and/or facilitates the plan for the best outcome

Assists with developing ongoing long-term care plans/service plans and works to identify providers, specialist, and/or community resources needed for long-term care

Coordinates as appropriate between the member and/or family/caregivers and the care provider team to ensure identified services are accessible to members

Provides resource support to members and their families/caregivers for various needs (e.g. employment, housing, participant direction, independent living, justice, foster care) based on service assessment and plans

Monitors care plans/service plans, member status and outcomes, as appropriate, and provides recommendations to care plan/service plan based on identified member needs

Interacts with long-term care healthcare providers and partners as appropriate to ensure member needs are met

Collects, documents, and maintains long-term care member information and care management activities to ensure compliance with current state, federal, and third-party payer regulators

May perform on-site visits to assess member's needs and collaborates with providers or resources, as appropriate

Provides and/or facilitates education to long-term care members and their families/caregivers on procedures, healthcare provider instructions, service options, referrals, and healthcare benefits

Performs other duties as assigned

Additional Sills: