Job Description

YOUR ROLE

The Case Manager will be responsible for providing evidence-based, short-term case management services to long-term care insurance policyholders who have a high probability of recovering from a functional or cognitive loss.

YOUR RESPONSIBILITIES

You will perform person-centered, strength-based case management services, both telephonically and in writing, with the insured and their family members. This includes reviewing their in-person functional and cognitive assessment and associated Plan of Care, empowering the insured to set recovery expectations and appropriate goals related to independence, frequently monitoring progress, evaluating results and pertinent medical records, and ultimately working towards a goal of termination of services due to recovery.

You will be able to comprehensively assess and address the insured’s biological, psychological and social needs on an ongoing basis.  This includes providing education on common medical conditions using understandable terms and may include coaching caregivers on how to best support the insured.

You will feel comfortable developing a warm and professional rapport with the insured’s care team (family, physicians, care providers) and when appropriate, will effectively integrate input them into the Plan of Care. This candidate will be able to anticipate and help the insured to problem solve common barriers to recovery and will adjust goals as appropriate to motivate and engage the insured. This may include suggesting referrals to specialists, recommending home modifications, researching appropriate equipment, and connecting the insured to resources.

You will need to research local/state/federal resources and services for the insured and be comfortable advocating for them if requested. This position will identify, request, and analyze pertinent medical records required to best understand the disease progression, ADL and IADL loss and potential for recovery. 

You will work independently and in a team environment and will manage and prioritize a work queue and multiple job responsibilities and will identify process improvement opportunities, provide feedback on processes and case management model as well as be a critical team member in enhancing the team’s performance and results.

YOUR QUALIFICATIONS

College degree in a field related to care management (counseling, gerontology, mental health, nursing, occupational therapy, physical therapy, psychology, or social work).

At least 2 years of supervised case management experience with older adults and their families (hospital, nursing home, or community placements).

Superior written and verbal communication and customer service skills

Able to effectively motivate individuals with post-operative musculoskeletal, neurological and general acute problems and communicate and execute appropriate Plans of Care.

Demonstrated experience in making sound business decisions using risk management and quality protocols.

Work effectively in a team environment or independently.

Professional and personal effectiveness in establishing relationships with customers, care providers, discharge planners, vendors, peers and Claims associates.

Ability to work with outside vendors to ensure a reasonable Plan of Care is in place.

Ability to understand and Interpret Insurance Contracts and Long Term Care Benefits.

Able to understand and interpret Physician Records and Occupational/Physical Therapist records and understand disease progression and recovery expectations. 

Understanding of single and cumulative medical conditions (particularly those common in the aging process), including their effect on physical/cognitive function, as well as their prognosis and rehabilitative potential.

ADDITIONAL QUALIFICATIONS

Graduate degree, certificate, or training in gerontology/geriatrics is preferred.

Strong knowledge of care, treatment, community programs, equipment and devices used to assist individuals with functional & cognitive impairments in regaining optimal independence.

Experience in using Windows applications (e.g. letter writing, spreadsheets, databases).

Strong knowledge of senior/geriatric/home health care, continuum of care, long-term care insurance and/or the Medicare program.

Good working knowledge of systems applications (e.g. WORD, EXCEL, PowerPoint, etc.). Willingness to learn claims and workflow systems.

WHY WORK AT GENWORTH

We have a real impact on the lives of the people we serve

We work on challenging and rewarding projects

We give back to the communities where we live

We offer competitive benefits including:

Medical, Dental, Vision, Flexible Spending Account benefit options available beginning your first day  

Generous Choice Time Off your first full year

12 Paid Holidays

40 hours of volunteer time off

401K Account with matching contributions

Tuition Reimbursement and Student Loan Repayment

Paid Family Leave

Child Care Subsidy Program