Community Health Care Manager.

7 days ago

Loveland, United States North Colorado Health Alliance Full time
Job DescriptionJob Description

Community Health Care Manager

 

Community Health Care Managers work in collaboration with local physical and behavioral health care providers, community agencies, and members enrolled in Medicaid to coordinate their care and connect them to valuable resources in the community.  By identifying health and wellness goals of the individuals they serve, Community Health Care Managers strive to improve individual health outcomes and improve that member’s experience in navigating the healthcare system, while working to reduce the high utilization costs of health care.  Community Health Care Managers focus on meeting individuals “where they are at”, work to improve each individual’s understanding of how to utilize local resources for self-management of their health and wellness, provide education related to navigation of the health care system, and rely on data to measure and enhance performance.

 

Knowledge / Skills / Abilities 

 

·         Cultural Competence

·         Critical Thinking Skills

·         Strong decision-making skills

·         Strong verbal communication skills (both over the phone and in-person)

·         Basic Business writing skills

·         Strong customer service skills

·         Ability to work independently and in a busy office environment that may contain interruptions to work due to walk-ins, member needs, supervisor requests, phone conversations, etc.

·         Ability to manage stressful situations while remaining calm and non-reactive (i.e. working with members who may have severe and persistent mental health issues or substance use disorders)

·         Ability to utilize positive problem solving in difficult situations

·         Multi-tasking, prioritizing, and ability to handle multiple priorities while meeting deadlines

·         Computer skills including Microsoft Office (Outlook/Excel/Word), state administered data collection systems, and other programs as needed or requested.  Experience working with EMRs preferred

·         Experience partnering with local and regional health and human service resources

·         Experience working with Medicaid and Medicare

·         Clinical skills including effectively engaging with multicultural populations and a variety of medical, behavioral health, justice involved, substance use, and homeless issues

·         Strict Confidentiality

·         Bilingual preferred (not required)

·         Reliable transportation and a valid driver license and insurance

 

Education or Formal Training

·         HS Graduate or GED required

 

Licensure/Certifications

·         Valid Colorado Driver License and Insurance required                                                                                                                                                         

 

Work Environment Physical Requirements

·         Frequent contact with the public by phone and in person

·         Sitting for periods of time while utilizing a PC or laptop

·         Standing for periods of time on uneven ground at times

·         Walking for periods of time on uneven ground at times

·         Climbing up and down stairs

·         Bending and reaching

·         Lifting up to 30 pounds

·         May be exposed to weather elements such as heat, rain, snow, etc. during member engagements

·         Work in confined spaces within proximity to other staff, noise, and discussions

 

Job Responsibilities/ Essential Functions:

·         Case Management and Care Coordination of assigned members

·         Monitor members according to guidelines set by NCHA Policy and Procedure under the Care Management guidelines

·         Participate in home visits, telephone contacts, office/hospital visits, and other means of connecting with members to reach identified goals

·         Perform needs assessments and identify risk factors to develop person centered care plans

·         Assist members in scheduling appointments, follow-up care, referrals, medication refills, etc.

·         Attend member appointments with providers and community resources as needed

·         Participate in health promotion and health education activities for members as identified in their health care plan

·         Establish collaboration, communication, and coordination among all responsible parties of an individual member’s multidisciplinary health care team and maintain routine correspondences

·         Work in conjunction with various providers to develop interventions as needed

·         Optimize member and family self-management through education, community resources, and support

·         Review appropriate cost-effective care and decrease duplication of services for members

·         Enter all documentation, contacts, and assessments into multiple databases

·         Timely responsiveness to emails, calls, and requests with a reply indicating understanding

·         Review appropriate cost-effective care and decrease duplication of services for members

·         Understand, communicate, and facilitate member’s complaints, grievances, and appeal processes

·         Regular case review with supervisor

·         Strict confidentiality of member records and communications following HIPAA Law

·         Personal accountability for training and education comprehension and implementation

 

Other Duties as Assigned:

·         Provide assistance as designated by Care Management leadership to support the overall goals of NCHA

·         Provide input into development of policies and procedures and be accountable for adhering to them

·         Compliance with all NCHA programs to exercise due diligence to prevent, detect, and report unlawful or unethical conduct by fellow co-workers, professional affiliates, and/ or agents

·         Participation in ongoing performance improvement activities

·         Provide oversight to students or guests wanting to learn about care management

·         Other duties as needed to meet demands of the organization (may include flexing or changing job location)

 

The above job definition information has been designed to indicate the general nature and level of work performed by employees within this classification. It is not designed to contain or be interpreted as a comprehensive inventory of all duties, responsibilities, and qualifications required of employees assigned to this job. Job duties and responsibilities are subject to change based on changing business needs and conditions.
 

Company DescriptionThe North Colorado Health Alliance convenes partners and co-workers in education, community service, health care, business, faith-based organizations, and government. The Alliance’s mission is to see Northern Colorado become the healthiest region in the healthiest state by developing and supporting a healthy population with 100% access to quality service and care at a sustainable cost.Company DescriptionThe North Colorado Health Alliance convenes partners and co-workers in education, community service, health care, business, faith-based organizations, and government. The Alliance’s mission is to see Northern Colorado become the healthiest region in the healthiest state by developing and supporting a healthy population with 100% access to quality service and care at a sustainable cost.

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