Job Description

Position Title

In House Certification Manager

Location

This position is available to Virginia residents as Richmond, Virginia in-office applicants or Lynchburg, Virginia in-office applicants or remote applicants residing in states/locations under Eastern or Central Standard Time: Alabama, Arkansas, Connecticut, Delaware, Florida, Georgia, Illinois, Indiana, Iowa, Kansas, Kentucky, Louisiana, Maine, Maryland, Massachusetts, Michigan, Minnesota, Mississippi, Missouri, Nebraska, New Hampshire, New Jersey, New York, North Carolina, North Dakota, Ohio, Oklahoma, Pennsylvania, Rhode Island, South Carolina, South Dakota, Tennessee, Texas, Virginia, Washington DC, Vermont, West Virginia or Wisconsin.

Your Role
The Care Management Team IHC Manager will be responsible for improving our in-house certification care management functions by providing updates to the plan of care and/or by completing assessments and monitoring for low-risk claimants. This position may lead a small team of associates focused on on/ post claim initiatives. This position will promote the provision of 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.

What You Will Be Doing

• You will be responsible for updating the plan of care for policyholders. This may include recommending certain types of durable medical equipment that would relieve the need for direct physical assistance or recommending a change in service hours based on reported activities of daily living. You will need to either coach the associate requesting the change in the proper questions to ask to clarify the need or to communicate with the claimant, family, caregiver, or agency to discern the care provided.
• You will be responsible for providing 90-day certifications for claimants who would like to pursue opening a claim for equipment only benefits. You will monitor the overall flow of this cohort by sending frequent status updates to the team members processing the payments and by maintaining weekly accurate reporting of the closure and payment statistics for this cohort.
• You will help to liaison between the Care Management team and other Claims departments or Genworth departments who would benefit from partnership. Departments may include Intake, Payments, Customer Service, Government Relations, Legal/Compliance, and CareScout.
• You may 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 working towards a goal of termination of services due to recovery.
• You may comprehensively assess and address the insured\xe2\x80\x99s 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 be responsible for professional engagement with the insured and their care team (family, physicians, care providers) and when appropriate, will effectively integrate input from 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.
• If requested, you may need to research local/state/federal resources and services for the insured and be comfortable advocating for them as needed.
• As appropriate, you may be responsible for identifying, requesting, and analyzing pertinent medical records required to best understand the disease progression, ADL/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. You 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\xe2\x80\x99s performance and results.

Must Have/What You Bring

• License in Social Work or Registered Nurse
• Certification from an ALCA accepted Care Management certification body
• Minimum Bachelor\xe2\x80\x99s degree in psychology, social work/ nursing, or a related field
• A minimum of 5 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.

Nice to Have

• 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.

What We Offer

• 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 options 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

About Us

Genworth Financial, Inc. (NYSE: GNW) is a Fortune 500 provider of products, services and solutions that help families address the financial challenges of aging. Headquartered in Richmond, Virginia, we apply our nearly 150 years of experience each day to helping people navigate caregiving options and fund their long-term care needs. Genworth is also the parent company of publicly traded Enact Holdings, Inc. (Nasdaq: ACT), a leading U.S. mortgage insurance provider. For more information on Genworth, please visit . From time to time Enact separately releases financial and other information about its operations. This information can be found at .

The mission of Genworth\xe2\x80\x99s US Life business is to efficiently keep our promises to our customers and their families and to lead the industry forward to solve the nation\xe2\x80\x99s long term care crisis.

We know we can\xe2\x80\x99t deliver on our mission unless we deliver for our employees. That\xe2\x80\x99s why we\xe2\x80\x99re committed to creating a work environment that fosters diversity, inclusion, camaraderie, rewarding work, community involvement, and a focus on our employees\xe2\x80\x99 well-being. We know each employee contributes in their own unique way and we\xe2\x80\x99re dedicated to supporting every one of them to help them reach their full potential.

Genworth