What are the responsibilities and job description for the Licensed Care Specialist position at SILAC Insurance Company?
About SILAC
SILAC Insurance Company is one of the fastest-growing insurance companies in the nation and continues to be a top contender in the industry. SILAC offers industry-leading annuity products that help individuals prepare for retirement. Teams can align around a shared vision of providing clean, simple & competitive products for clients, delivering best-in-class service to agents & business partners, and propelling the success of our employees.
With a fast-growing team of more than 300 employees, we are committed to remaining adaptable, innovative, and trustworthy for our clients, agents, and employees.
We hold true to our core values:
- Adaptability & Continuous Improvement
- Transparency & Trust, Honesty & Integrity
- Teamwork & Collaboration
- Gratitude & Compassion
At SILAC Insurance Company, we welcome and encourage diversity and are dedicated to creating an environment and culture that is respectful and inclusive for everyone.
Licensed Care Specialist
Job Overview: Determine claims eligibility and manage cost effective care planning for Long Term Care (LTC) policyowners. Coordinate with other LTC Department staff to provide personalized customer service, by accurately administering LTC claims and clearly communicating policy language. Develop and update care plans and advise customers and SILAC staff on the impact of medical and other functional conditions.
Job Details
Starting Pay Rate: $30.00
Full Time or Part Time: Full Time
Standard Hours Per Week: Monday - Friday, 40 hours/week
Work Schedule: Shift starts between 6:00 AM and 9:00 AM MT
Schedule Type: In-Office
What you'll do:
Eligibility Review - Conduct review of all relevant documents (care plans, assessments, medical records, etc.) to determine eligibility for benefits. Conduct reassessments as needed to determine continued eligibility.
Care Plan Development - Develop cost effective care plans: evaluating type, timing, and place of care, to serve as a guide for caregivers and as a tool for SILAC's care management. Determine expected duration of care and revise plans to reflect changes in condition and ability. Ensure planning is consistent with all available informational records including functional assessments.
Processes, Procedures, and Guidelines - Contribute to the improvement of written processes, procedures, and guidelines for care coordination, ensuring consistency with other LTC Department functioning. This includes initiating improvement in efficiency using better methods and automated systems.
Communication - Communicate and explain care planning to customers, care providers, agents, and SILAC staff, by showing consistency with evidence from provider records and functional assessments. Coordinate and communicate with other SILAC leadership, medical consultants, auditors, and other industry professionals.
Chronically Ill Certification - Sign Chronically Ill Certifications for all tax-qualified policies on claim at least annually.
Other Administrative Functions - Assist as requested with tasks and projects such as claim appeals, legal disputes, and revision of forms and documents.
Report to and perform other work or projects as directed by the L&H Eligibility Manager.
Job Requirements
Who you are:
Required
- Bachelor of Science in Nursing, and licensed as a Registered Nurse (RN), Licensed Practical Nurse (LPN), or Licensed Clinical Social Worker (LCSW), or other similar licensure or degree.
- 1 year experience in care management or 2 years clinical experience (preferably with geriatric clients) assessing, planning, and coordinating care.
- Ability to accurately assess policyowner needs and create individualized care plans.
- Experience in communicating professionally, patiently, and clearly in speech and in writing.
- Ability to research and logically consider details from many sources, and to bring them together to support a conclusion.
- Experience using PC applications such as MS Word, Excel, Teams, and Outlook.
- Detail-oriented with the ability to complete tasks with accuracy and in a timely manner.
- Demonstrated ability to work independently while managing workload and meeting time-sensitive deadlines.
Desired
- Care Manager, Certified (CMC) designation through the National Academy of Certified Care Managers (NACCM).
- Geriatric client experience.
- Long Term Care, disability, or other insurance claims experience.
- Insurance experience in cost containment.
- Knowledge of state regulations and requirements, Anti-Money Laundering procedures and identifying potential fraud or elderly abuse situations.
BENEFITS:
- Medical Plans, including FSA and HSA
- Dental and Vision
- 401(k) (Roth and Traditional)
- Pet Insurance
- Parental Leave
- Paid Time and Sick Time off
- 10 Paid Holidays and 1 Birthday Pay
- Paid Volunteer Time
- College Tuition Reimbursement
Communication during the recruitment process regarding interview requests or job offers will come directly from a recruiting team member with a silacins.com email address.
At SILAC, we celebrate a diverse and inclusive work environment, where we honor and support varying backgrounds, beliefs, and perspectives for the benefit of our business, including our employees and products. We are proud to be an equal-opportunity workplace and strive to be a place where every employee feels they belong. We are committed to equal employment opportunity regardless of race, color, ancestry, religion, sex, national origin, sexual orientation, age, citizenship, marital status, disability, gender identity, or Veteran status. If you have a disability or a special need that requires accommodation, please let us know.
Salary : $30
