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Case Manager Long-term Care - Delaware (Kent, Sussex, New Castle)

April 29, 2026

<h2>Company :</h2>Highmark Inc.<h2>Job Description : </h2>JOB SUMMARYThis job serves as the single point of contact for members to coordinate all of the member’s care needs across the various service delivery systems and community supports. This is a full-time community-based position requiring frequent travel within the assigned territory in DE. A significant portion of this role involves working directly with members in their homes and also requires providing case management services within nursing facility settings. The incumbent will travel to members’ homes, nursing facilities, and other community-based settings for individuals enrolled in DSHP Plus LTSS and DSNP. ESSENTIAL RESPONSIBILITIES<ul><li>Conduct regular in-home and nursing facility visits: Travel to members’ homes, nursing facilities, and other community-based settings to complete face to face needs assessments with subsequent telephonic contact with the member in accordance with state and national guidelines, policies, procedures, and protocols. This includes actively working within the nursing facility environment and participating in NF care plan conferences to ensure member needs are met. </li><li>Assess, plan, coordinate, implement and evaluate care for eligible members with chronic and complex health care, social service and custodial needs in a nursing facility or home and community-based care setting.</li><li>Coordinate care across the continuum of services and assisting members physical, behavioral, long term services and supports (LTSS), social, and psychosocial needs in the safest, least restrictive way possible while considering the most cost-effective way to address those needs. This includes ensuring appropriate care transitions between home, community, and community-based care settings. </li><li>Authorize LTSS services based upon completion of a comprehensive needs assessment. Coordinate HCBS services, Medicaid and DSNP benefits and assess appropriateness of care and services in community. </li><li>Facilitate transitions to alternate care settings such as hospital to home, nursing facility to community setting using an integrated care team to address the member’s specific needs.</li><li>Educate members or caregivers regarding health care needs, available benefits, resources and services including available options for long term care community or facility-based service delivery.</li><li>Provide education, resources, and assistance to help members achieve goals as outlined in their plan of care and to overcome obstacles to achieving optimal care in the least restrictive environment.</li><li>Develop individualized care plans in conjunction with members or caregivers to identify services to meet the member’s specific needs, and goals.</li><li>Identify resources needed for a fully integrated care coordination approach including facilitating referrals to special programs such as Disease/Chronic Condition Management, Behavioral Health, and Complex Case Management.</li><li>Collaborate with the member's health care and service delivery team including the physical, behavioral health providers, ICT, and discharge planners, to coordinate the care needs and community resources for the member to maintain the member in the least restrictive safe environment possible.</li><li>Assist members in developing, implementing and amending a back-up plan for gaps in provider coverage.</li><li>Ensure approved support services are being provided as outlined in the plan of care.</li><li>Evaluate the effectiveness of the service plan and making appropriate revisions as needed in accordance with per policy & procedures and state contractual requirements.</li><li>Assist members in overcoming obstacles to optimal care through connection with community resources, including communicating with providers and formulating an appropriate action plan.</li><li>Document all case management services and intervention in the electronic health record.</li><li>Adhere to all company, State and Federal requirements related to privacy practices, HIPAA, and quality performance standards.</li><li>Perform other duties as assigned/requested.</li></ul>QUALIFICATIONSRequired<ul><li>Bachelor's degree in Social Work or in health, human, or education services and 3 years of experience in long-term care, home health, hospice, public health, or assisted living OR</li><li>Master’s degree in Social Work or in health, human, or education services and 1 year of experience in long-term care, home health, hospice, public health, or assisted living OR</li><li>Current State RN or LPN licensure OR Current multi-state licensure through the enhanced Nurse Licensure Compact (eNLC) and 2 years of experience in long-term care, home health, hospice, public health, or assisted living OR</li><li>A high school degree or equivalent and three years of qualifying experience with case management of the aged, including management of behavioral health conditions, or persons with physical or developmental disabilities, or HIV/AIDS population.</li></ul>Substitutions<ul><li>None</li></ul>Preferred<ul><li>One year in home clinical or case management experience</li><li>Certified Case Manager (CCM)</li><li>Licensed Bachelors Social Worker (LBSW)</li><li>Licensed Masters Social Worker (LMSW)</li><li>Licensed Clinical Social Worker (LCSW)</li><li>Experience working with HIV/AIDS population</li><li>Experience working with behavioral health population</li><li>Experience working with developmental disabilities population </li><li>Medicare and Medicaid experience</li><li>Managed care experience</li></ul>SKILLS<ul><li>Working flexible hours to meet member’s needs</li><li>Proficiency in PC-based word processing and database documentation (Word, Excel, Internet, Outlook)</li><li>Reliable transportation daily to be able to travel within assigned territory</li><li>Ability to meet regulatory deadlines.</li><li>Has a dedicated home work space used only for business purposes and is able to comply with all telecommuter policies.</li><li>Experience in geriatric special needs, behavioral health, home health</li><li>Understanding of the importance of cultural competency in addressing targeted populations.</li><li>Experience with electronic documentation system(s)</li><li>Experience with cost neutrality and budgeting</li></ul>Language (Other than English):NoneTravel Requirement:25% - 50%PHYSICAL, MENTAL DEMANDS and WORKING CONDITIONSPosition TypeWorks From HomeTeaches / trains others regularlyOccasionallyTravel regularly from the office to various work sites or from site-to-siteOccasionallyWorks primarily out-of-the office selling products/services (sales employees)NeverPhysical work site requiredYesLifting: up to 10 poundsConstantlyLifting: 10 to 25 poundsOccasionallyLifting: 25 to 50 poundsRarelyDisclaimer: The job description has been designed to indicate the general nature and essential duties and responsibilities of work performed by employees within this job title. It may not contain a comprehensive inventory of all duties, responsibilities, and qualifications required of employees to do this job. Compliance Requirement: This job adheres to the ethical and legal standards and behavioral expectations as set forth in the code of business conduct and company policies. As a component of job responsibilities, employees may have access to covered information, cardholder data, or other confidential customer information that must be protected at all times. In connection with this, all employees must comply with both the Health Insurance Portability Accountability Act of 1996 (HIPAA) as described in the Notice of Privacy Practices and Privacy Policies and Procedures as well as all data security guidelines established within the Company’s Handbook of Privacy Policies and Practices and Information Security Policy. Furthermore, it is every employee’s responsibility to comply with the company’s Code of Business Conduct. This includes but is not limited to adherence to applicable federal and state laws, rules, and regulations as well as company policies and training requirements. Pay Range Minimum:$72,700.00Pay Range Maximum:$116,600.00Base pay is determined by a variety of factors including a candidate’s qualifications, experience, and expected contributions, as well as internal peer equity, market, and business considerations. The displayed salary range does not reflect any geographic differential Highmark may apply for certain locations based upon comparative markets.Highmark Health and its affiliates prohibit discrimination against qualified individuals based on their status as protected veterans or individuals with disabilities and prohibit discrimination against all individuals based on any category protected by applicable federal, state, or local law.We endeavor to make this site accessible to any and all users. If you would like to contact us regarding the accessibility of our website or need assistance completing the application process, please contact the email below.For accommodation requests, please contact HR Services Online at <a href="mailto:HRServices@highmarkhealth.org" target="_blank" rel="noopener noreferrer">HRServices@highmarkhealth.org</a><a href="https://dokumfe7mps0i.cloudfront.net/oms/4391/document/2026/1/doclib_458575_QLVK9_1769448333304228022_1769448333396/1769448333396.pdf" target="_blank" rel="noopener noreferrer">California Consumer Privacy Act Employees, Contractors, and Applicants Notice</a>

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Common Interview Questions And Answers

1. HOW DO YOU PLAN YOUR DAY?

This is what this question poses: When do you focus and start working seriously? What are the hours you work optimally? Are you a night owl? A morning bird? Remote teams can be made up of people working on different shifts and around the world, so you won't necessarily be stuck in the 9-5 schedule if it's not for you...

2. HOW DO YOU USE THE DIFFERENT COMMUNICATION TOOLS IN DIFFERENT SITUATIONS?

When you're working on a remote team, there's no way to chat in the hallway between meetings or catch up on the latest project during an office carpool. Therefore, virtual communication will be absolutely essential to get your work done...

3. WHAT IS "WORKING REMOTE" REALLY FOR YOU?

Many people want to work remotely because of the flexibility it allows. You can work anywhere and at any time of the day...

4. WHAT DO YOU NEED IN YOUR PHYSICAL WORKSPACE TO SUCCEED IN YOUR WORK?

With this question, companies are looking to see what equipment they may need to provide you with and to verify how aware you are of what remote working could mean for you physically and logistically...

5. HOW DO YOU PROCESS INFORMATION?

Several years ago, I was working in a team to plan a big event. My supervisor made us all work as a team before the big day. One of our activities has been to find out how each of us processes information...

6. HOW DO YOU MANAGE THE CALENDAR AND THE PROGRAM? WHICH APPLICATIONS / SYSTEM DO YOU USE?

Or you may receive even more specific questions, such as: What's on your calendar? Do you plan blocks of time to do certain types of work? Do you have an open calendar that everyone can see?...

7. HOW DO YOU ORGANIZE FILES, LINKS, AND TABS ON YOUR COMPUTER?

Just like your schedule, how you track files and other information is very important. After all, everything is digital!...

8. HOW TO PRIORITIZE WORK?

The day I watched Marie Forleo's film separating the important from the urgent, my life changed. Not all remote jobs start fast, but most of them are...

9. HOW DO YOU PREPARE FOR A MEETING AND PREPARE A MEETING? WHAT DO YOU SEE HAPPENING DURING THE MEETING?

Just as communication is essential when working remotely, so is organization. Because you won't have those opportunities in the elevator or a casual conversation in the lunchroom, you should take advantage of the little time you have in a video or phone conference...

10. HOW DO YOU USE TECHNOLOGY ON A DAILY BASIS, IN YOUR WORK AND FOR YOUR PLEASURE?

This is a great question because it shows your comfort level with technology, which is very important for a remote worker because you will be working with technology over time...