Supervisor Case Manager Long-term Care - Delaware (Kent, Sussex, New Castle)
Highmark, Wilmington, DE, United States
Job Summary
This position manages a team of Case Managers to promote quality member outcomes, optimize member benefits, and ensure effective use of resources for members enrolled in DSHP Plus LTSS. The manager provides direct oversight, meets all Case Manager requirements, and assists with day‑to‑day responsibilities as needed. This full‑time, community‑based role requires frequent travel within Delaware.
Essential Responsibilities
Manage a team of community‑based Case Managers.
Promote quality member outcomes and optimize member benefits while ensuring effective use of resources.
Serve as a role model and assist staff with day‑to‑day activities as required.
Ensure care is medically appropriate, high quality, and cost‑effective.
Conduct frequent ride‑alongs and shadowing of Case Managers for hands‑on support, quality assurance, and training.
Apply clinical knowledge to coordinate care with facilities and providers.
Participate in rounds with the Medical Director.
Review documentation and processes for consistency and identify opportunities for growth.
Initiate and implement process improvements.
Assist Case Managers in resolving challenging situations and achieving member needs.
Escalate issues appropriately.
Suggest new approaches to complex problems.
Ensure all staff reach the minimal qualification of their position through ongoing development and education.
Ensure direct reports meet documentation and process standards for compliance with regulatory agencies such as NCQA, URAC, CMS, DOH, and DOL.
Develop and implement workload modifications to meet Delaware Case Manager caseload requirements.
Recruit, select, orient, evaluate, counsel, and develop performance plans; promote and terminate in accordance with corporate policy; encourage career development.
Adhere to all privacy, HIPAA, and quality performance standards.
Perform other duties as assigned.
Qualifications
Required:
Bachelor’s degree in Social Work or health, human, or education services and 3 years of experience in long‑term care, home health, hospice, public health, or assisted living.
Master’s degree in Social Work or health, human, or education services and 1 year of the same experience.
Registered Nurse or Licensed Practical Nurse with 2 years of experience in the same settings.
Substitutions: RN or LPN with 2 years of experience in lieu of a Bachelor’s degree.
Preferred:
Two years of supervisory or managerial experience.
Certified Case Manager (CCM).
Licenses: Licensed Bachelor Social Worker (LBSW), Licensed Master Social Worker (LMSW), Licensed Clinical Social Worker (LCSW).
Experience with HIV/AIDS, behavioral health, developmental disabilities populations.
Home clinical or case management experience of at least two years.
Medicare and Medicaid experience.
Managed care experience.
Skills
Leadership skills with the ability to relate to all management levels and external stakeholders.
Collaboration and motivational skills.
Ability to multi‑task in a fast‑paced and often intense environment.
Excellent written and verbal communication.
Analytical and organizational skills; ability to analyze data, measure outcomes, and develop action plans.
Team player with strong analytical and organizational skill set.
Prioritization and meeting deadlines.
Proficiency in PC‑based word processing and database documentation (Word, Excel, Internet, Outlook).
Reliable transportation for travel within assigned territory.
Ability to meet regulatory deadlines.
Dedicated home workspace compliant with telecommuter policies.
Experience with geriatric special needs, behavioral health, and home health.
Cultural competency in addressing targeted populations.
Experience with electronic documentation systems.
Understanding of cost neutrality and budgeting.
Scope of Responsibility
Yes, this role supervises and manages other employees.
Work Environment
Travel required: Yes.
Pay Range
$86,400.00 – $138,600.00. Base pay is determined by qualifications, experience, and contributions.
EEO Statement
Highmark Health and its affiliates prohibit discrimination against qualified individuals based on veteran or disability status and against all individuals based on any protected category as required by federal, state, and local law. We endeavor to make this site accessible to all users and provide accommodations as needed.
California Consumer Privacy Act Notice
Employees, contractors, and applicants receive notice regarding the California Consumer Privacy Act. For accommodation requests, contact HR Services Online at HRServices@highmarkhealth.org.
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This position manages a team of Case Managers to promote quality member outcomes, optimize member benefits, and ensure effective use of resources for members enrolled in DSHP Plus LTSS. The manager provides direct oversight, meets all Case Manager requirements, and assists with day‑to‑day responsibilities as needed. This full‑time, community‑based role requires frequent travel within Delaware.
Essential Responsibilities
Manage a team of community‑based Case Managers.
Promote quality member outcomes and optimize member benefits while ensuring effective use of resources.
Serve as a role model and assist staff with day‑to‑day activities as required.
Ensure care is medically appropriate, high quality, and cost‑effective.
Conduct frequent ride‑alongs and shadowing of Case Managers for hands‑on support, quality assurance, and training.
Apply clinical knowledge to coordinate care with facilities and providers.
Participate in rounds with the Medical Director.
Review documentation and processes for consistency and identify opportunities for growth.
Initiate and implement process improvements.
Assist Case Managers in resolving challenging situations and achieving member needs.
Escalate issues appropriately.
Suggest new approaches to complex problems.
Ensure all staff reach the minimal qualification of their position through ongoing development and education.
Ensure direct reports meet documentation and process standards for compliance with regulatory agencies such as NCQA, URAC, CMS, DOH, and DOL.
Develop and implement workload modifications to meet Delaware Case Manager caseload requirements.
Recruit, select, orient, evaluate, counsel, and develop performance plans; promote and terminate in accordance with corporate policy; encourage career development.
Adhere to all privacy, HIPAA, and quality performance standards.
Perform other duties as assigned.
Qualifications
Required:
Bachelor’s degree in Social Work or health, human, or education services and 3 years of experience in long‑term care, home health, hospice, public health, or assisted living.
Master’s degree in Social Work or health, human, or education services and 1 year of the same experience.
Registered Nurse or Licensed Practical Nurse with 2 years of experience in the same settings.
Substitutions: RN or LPN with 2 years of experience in lieu of a Bachelor’s degree.
Preferred:
Two years of supervisory or managerial experience.
Certified Case Manager (CCM).
Licenses: Licensed Bachelor Social Worker (LBSW), Licensed Master Social Worker (LMSW), Licensed Clinical Social Worker (LCSW).
Experience with HIV/AIDS, behavioral health, developmental disabilities populations.
Home clinical or case management experience of at least two years.
Medicare and Medicaid experience.
Managed care experience.
Skills
Leadership skills with the ability to relate to all management levels and external stakeholders.
Collaboration and motivational skills.
Ability to multi‑task in a fast‑paced and often intense environment.
Excellent written and verbal communication.
Analytical and organizational skills; ability to analyze data, measure outcomes, and develop action plans.
Team player with strong analytical and organizational skill set.
Prioritization and meeting deadlines.
Proficiency in PC‑based word processing and database documentation (Word, Excel, Internet, Outlook).
Reliable transportation for travel within assigned territory.
Ability to meet regulatory deadlines.
Dedicated home workspace compliant with telecommuter policies.
Experience with geriatric special needs, behavioral health, and home health.
Cultural competency in addressing targeted populations.
Experience with electronic documentation systems.
Understanding of cost neutrality and budgeting.
Scope of Responsibility
Yes, this role supervises and manages other employees.
Work Environment
Travel required: Yes.
Pay Range
$86,400.00 – $138,600.00. Base pay is determined by qualifications, experience, and contributions.
EEO Statement
Highmark Health and its affiliates prohibit discrimination against qualified individuals based on veteran or disability status and against all individuals based on any protected category as required by federal, state, and local law. We endeavor to make this site accessible to all users and provide accommodations as needed.
California Consumer Privacy Act Notice
Employees, contractors, and applicants receive notice regarding the California Consumer Privacy Act. For accommodation requests, contact HR Services Online at HRServices@highmarkhealth.org.
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