Job ID 1160966 Category Medical Management Organization Pennsylvania Health and
Complete assessments with participants, caregivers, natural and community supports, or providers to obtain information regarding client status, support system, and need for services for person centered care plan development
Monitor delivery of services and follow-up with participants, caregivers, or providers through in person visits and telephonic contact. Authorize and coordinate referral for services. Ensure provider services are delivered without gaps and identify deficiencies in plans. Assist in coordinating the development of informal or voluntary services to integrate into the participants person centered service/care plan
Collaborate with discharge planners, physicians, and other parties to ensure appropriate discharge plan, care plan, and coordination of acute care and long term care services
Assist participant with filing and resolving complaints and appeals
Responsible for assisting participants with gaining access to needed services through coordination and integration of medical and long term care services for the purpose of orientation, person centered care plan development, assessment.
Registered Nurse (RN) or Bachelor’s Degree in social work, psychology, or related field. 3+ years of experience in a social service or health care related setting or 1 year of experience with LTSS or Managed Care. Licenses/Certifications: Valid driver’s license.
Location: Mansfield, PA