Licensed Clinical Specialist

Job Summary

Licensed Clinical Specialist, a full-time position responsible for delivering customer service and case management for long-term care insurance policyholders, conducting telephonic assessments, and improving certification functions.

Key Responsibilities

• Conduct telephonic assessments and communicate with medical personnel to develop care plans and provide certifications
• Analyze medical records to understand disease progression and care needs of insured individuals
• Identify process improvement opportunities and collaborate with team members to enhance performance and results

Required Qualifications

• Active Licensed Social Worker or Registered Nurse
• Minimum of two years of experience with medical conditions related to aging
• Ability to interpret MDS, Plan of Care, and medical records
• Experience in making business decisions using risk management protocols
• Familiarity with insurance contracts and Long-Term Care benefits