Culture Highlights!

• Flexible work environment – work from where it's most convenient, home or office.
• Flexible work model – flex your time to blend work and life to fit various lifestyles/needs.
• Monday through Friday schedule.
• 9 paid holidays, and 3 additional floating holidays (pro-rate applies).
• Volunteer in your community – 24 hours awarded annually.
• Professional Growth – internal and external learning and development opportunities.
• Robust Total Rewards – Medical/Dental/Vision, Telehealth, Flex Spending, 401k Matching, Life insurance, LT/ST Disability, EAP, & Mileage Reimbursement.

**Ideal candidate will be local in the Central and Northeastern service regions of Wisconsin to support IDT staff and members. Travel will be as needed.**

Position Summary:

Under the direction of the CM Utilization Supervisor, the Residential Utilization Specialist actively supports IDT staff’s utilization of the least restrictive and most integrated residential settings available to members. This role supports appropriate utilization of residential services, including finding the right fit for the right acuity. In addition, members with highly complex care planning needs will be supported through consultation with this position.

The Residential Utilization Specialist performs a unique role in utilizing organizational data, analyzing utilization trends, and comparing information to current policies, established guidelines, and LCI Membership. In addition to acting as a partner to Care Management, this position will routinely interface with other internal Divisions to support collaborative provider growth and development to ensure fiscal sustainability and appropriateness of service utilization.

Responsibilities & Competencies:

• Serve as a resource and collaborate through consultation with LCI’s Care Management staff to support comprehensive, outcome-based care planning for members with complex care planning needs, such as mental health support needs, behavioral health support needs, other challenging social or health determinants, etc.
• Review the member record and evaluate the impact of this information on the assessment and care planning process specific to the member’s potential need for residential services.
• Collect, analyze, and utilize data to support informed decision making for member care and provider needs to promote holistic care planning.
• Develop and analyze proactive indicators to address changing and emerging needs of members.
• Identify barriers to placement and address problems cooperatively as they occur.
• Collaborate with internal stakeholders, including CM Practice, Network Relations, and Business/Fiscal, to ensure quality and sustainability outcomes are met, as in alignment with our Strategic Plan and Goals.
• Liaison with community and provider stakeholders as needed to develop and strengthen our service delivery outcomes and sustainability, simultaneously.
• Works in partnership with others to develop and maintain cost-effective residential placement practices, implement quality improvement initiatives, conduct utilization review, and review the effectiveness of service coordination policies and procedures to ensure effective delivery of the Family Care benefit in alignment with members’ needs.
• Assist with reviewing solutions for gaps and/or quality concerns within the Provider Network as it relates to residential placement. Assist in reviewing for the proper utilization of related services including supportive home care, skilled nursing facilities, and crisis stabilization/diversion facilities.

Are you excited about this role but not sure if your work experiences align to the role or qualifications? We encourage you to apply anyway. At Lakeland Care, our values drive how we do our work and how we hire. We strive to build an inclusive, authentic workforce that embraces diversity and differences in strengths. So be sure to highlight your skill set and competencies you’re confident in! You may be the right candidate in disguise and/or for other roles.

• Bachelor’s degree in a Health or Human Services related field, or equivalent combination of education and experience (includes knowledge, skills, and abilities).
• Minimum of two (2) year’s professional experience in a long-term care organization or community-based setting required; work experience with one or more of the target groups served by Family Care preferred.
• Demonstrates proficiency in applying the Family Care principles and Resource Allocation Decision process to practice.
• Strong data analysis and application skills.
• Strong evaluation, assessment, and interview skills.
• Must demonstrate proficiency in Microsoft Office (Word, Excel, PowerPoint, Outlook).
• Must have exceptional verbal and written communication skills.
• Must have creative problem solving and critical thinking skills.
• Must have excellent organization and interpersonal skills.
• Must have strong analytical and negotiation skills.
• Ability to develop effective working relationships with providers, external stakeholders, and care management staff.
• Current driver’s license, acceptable driving record and proof of adequate insurance required.

Acknowledgement:

This position description describes the general nature and level of work performed by the individual assigned to this position and should not be interpreted as all inclusive. It does not state or imply these are the only duties and responsibilities assigned to the position. The employee may be required to perform other job-related duties. All requirements are subject to change and to possible modification to reasonably accommodate individuals with a disability.

This position description does not constitute an employment agreement between the employer and employee and is subject to change by the employer as the needs of the employer and requirements of the position change.

APPLICATION DEADLINE DATE: Accepting through 5/16/2023.

For questions on this role, please reach out to the Talent Acquisition Specialist Becky Vang at becky.vang@lakelandcareinc.com.

**COMPENSATION CAN BE DISCUSSED WITH HUMAN RESOURCES.**

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Lakeland Care is a Wisconsin-based non-profit organization that focuses on creating a world we all want to live in. With long-standing roots as a managed care organization (MCO), Lakeland Care provides long-term care services and supports to eligible frail elders and individuals with physical and intellectual or developmental disabilities to achieve their daily and lifelong goals through Wisconsin’s Family Care program. Currently we serve in 22 counties and have 11 offices in the Central to North East region of Wisconsin.

Our Mission

Empowering individuals. Strengthening communities. Inspiring futures.

Our Vision

To create a world we all want to live in.

Our Core Values

Kindness – We believe kindness is always possible and that no compassionate act is ever wasted.

Inclusion – We believe that open hearts and open minds are the only path to a brighter future.

Trust – We believe that honesty is still in style and that promises still have power.

We are an equal employment opportunity employer functioning under an Affirmative Action Plan. All qualified applicants will receive consideration for employment without regard to race, color, religion, gender, national origin, disability status, protected veteran status or any other characteristic protected by law. We are an organization that participates in E-Verify.