Case Management Assistant

4 weeks ago

Fresno, United States Universal Healthcare MSO LLC Full time
Job DescriptionJob DescriptionDescription:

Position Summary:

The Case Management Assistant provides support for the Case Management Department, including the Nurse Case Managers and Social Services team specifically through the coordination of services within the Enhanced Care Management (ECM) Program.

The Case Management Assistant will provide support by managing low acuity cases, assisting in enhanced care coordination activities, monitoring members, reporting findings, and gathering clinical information from outside sources.

The ECM Program addresses the clinical and non-clinical needs of members with the most complex medical and social needs through systematic coordination of services and comprehensive care management.

ECM is intended to service those with chronic health conditions, are homeless or at-risk, with high hospital admissions, substance abuse, and/or behavioral health needs. This position requires strong interpersonal and organizational skills to build rapport with members, coordinate referrals, and care amongst various healthcare providers and community services.

The Case Management Assistant also works with the member’s inter-disciplinary team (ICT) supporting the member, while engaging the member and their support systems to define priorities that are central to the member’s desired needs and goals.


Status: Full-Time

Work location: Onsite

Schedule: Monday-Friday 8am-5pm


Compensation:

The initial pay range for this position upon commencement of employment is projected to fall between $18.00 and $24.00. However, the offered base pay may be subject to adjustments based on various individualized factors, such as the candidate's relevant knowledge, skills, and experience. We believe that exceptional talent deserves exceptional rewards. As a committed and forward-thinking organization, we offer competitive compensation packages designed to attract and retain top candidates like you.


Job Duties and Responsibilities:

• Effectively manage low acuity member cases within the ECM Program.

• Contacts members at regular intervals per their acuity level and care plan needs.

• Completes member questionnaires or assessments, and consistently document care

management activities and encounters in the CM System, per program protocol.

• Works collaboratively and assists clinical and social services Case Managers with care

coordination, member follow-up, communication with appropriate agencies and

preparation and distribution of documents and/or reports.

• Works collaboratively and assists the Clinical or Social Services Case Managers to

manage members in need of Transitional Care Services (TCS).

• Gather clinical information and assists with coordinating post-discharge services, including scheduling provider appointments, ensuring post-discharge referrals are received by the member, transportation to appointments is arranged, and members are aware of follow-care needs.

• Proactively initiates care transition coordination with referral sources and internal partners to ensure seamless patient transitions to home or ATS. Participates with any data collection required for therapy start and patient tracking process. This may include facilitating the transfer of orders via phone, fax, and e-prescribing.

• Reports variances and issues to nursing or social services staff assigned to the member.

• Assists members with appointment scheduling, transportation, referral coordination, and other enhanced care coordination services.

• Responsible for gathering clinical information from outside sources such as PCPs, specialists and other providers, electronic health records, and other partnering entities.

• Verifies member eligibility, demographic information, and benefits.

• Verifies member's Primary Care Physician and the Physician Specialist to ensure that authorization is requested and issued to appropriate network provider.

• Assists in maintaining the integrity of the data systems by entering information into department’s data systems.

• Provides general office administration duties including answering phones.

•Provides general customer service to all potential and exiting ECM members and partnering agencies.

• Gathers relevant information for the identified member population during assessment,

care planning, interdisciplinary care team meetings, and transitions of care.

• Outreaches to members to verify that needs are being met and services are being delivered.

• Intervenes at the member level to coordinate the delivery of direct services to the member and their families.

• Serves as an associate and resource to members, providers, staff, and external customers

regarding policies, benefits, and care coordination.

• Assists with system letters, requests for information and data entry.

• Gather information, present, and participate in Interdisciplinary Care Team (ICT) meetings, and communicate the member’s needs and preferences in a timely manner to the member’s multi-disciplinary care team.

• Attend mandatory departmental and staff meetings.

• Assist with training and orientation of new staff.

• May be assigned to conduct in-person meetings with members during clinic visits.

• Assist case management team with oral interpretation, as applicable.

• Performs other duties as assigned.

Requirements:

Qualifications:

• Education: Education: High School diploma or GED required.

• Minimum of 3 years of experience working in a health care or community health setting.

• Knowledge of prior authorization or case management regulations governing Medi-Cal,

Commercial, Medicare, CCS, and other government and commercial programs.

• Experience in a managed health care environment preferred (IPA, HMO, or Health Plan).

• Medical Assistant or Community Health Worker certification preferred.


Knowledge and Skills

• Ability to respect the needs of members, support givers, team members, and others, and

provide excellent customer service.

• Willingness to collaborate as part of a team with professionals at all levels to achieve

goals and remove barriers to member health.

• Sensitivity to members' social, cultural, language, physical, and financial differences.

• Ability to work with members and influence behavior through negotiation of care goals

and support of member self-management.

• Strong problem-solving skills and ability to identify issues and propose solutions.

• Ability to prioritize tasks based on changes in member situations and needs.

• Ability to work independently, organize and prioritize multiple tasks throughout the day.

• Strong attention to detail and ability to be accurate, thorough, and persistent in problem solving and task completion.

• Excellent verbal and written communication skills, with the ability to communicate effectively with all levels of the organization and members.

• Proficiency in creating professional documents with proper grammar and punctuation.

• Ability to maintain professionalism and adapt to a changing environment.

• Ability to understand and communicate complex health and benefit information.

• Proficient in the use of common office technology, including electronic Case

Management systems.

• Reliable in attendance and adherence to work schedule and business dress code.

• Ability to always maintain strict confidentiality.

  • Case Manager

    5 hours ago

    Fresno, California, United States Sevita Full time

    About SevitaSevita is a mission-driven organization that provides community-based services for individuals with intellectual and developmental disabilities. Our goal is to empower individuals to live well and have a fulfilling career.Job SummaryWe are seeking a skilled Case Manager to join our team. As a Case Manager, you will provide case management...

  • Case Manager

    2 days ago

    Fresno, United States Sevita Full time

    Mentor Community Services , a part of the Sevita family, provides community-based services for individuals with intellectual and developmental disabilities. Here we believe every person has the right to live well, and everyone deserves to have a fulfilling career. You’ll join a mission-driven team and create relationships that motivate us all every day....

  • Housing Case Manager

    3 months ago

    Fresno, United States Elevate Community Services Inc Full time

    Job DescriptionJob DescriptionThe Housing Case Manager is responsible for providing case management and navigation to individuals currently residing in our emergency shelters. Position SummaryElevate Community Services is hiring a Housing Case Manager for the Emergency Shelters. The Housing Case Manager assists with the housing search and placement along...

  • Case Manager

    5 hours ago

    Fresno, California, United States Mental Health Systems, Inc. Full time

    Job SummaryMental Health Systems, Inc. is seeking a highly skilled and compassionate Case Manager to join our team. As a Case Manager, you will play a critical role in providing comprehensive support services to clients, ensuring their needs are met and their goals are achieved.Key ResponsibilitiesCase Management: Provide individualized case management...

  • Lead Housing Case Manager

    3 months ago

    Fresno, United States Elevate Community Services Inc Full time

    Job DescriptionJob DescriptionPosition Summary The Lead Housing Case Manager will work with clients in the emergency shelter and assist clients with transitioning into permanent housing. The Lead Housing Case Manager will assist clients with obtaining documents needed for housing, locating appropriate housing, increasing income, and remaining successfully...

  • Bilingual Lead Case Manager

    2 months ago

    Fresno, United States RH Community Builders Full time

    RH Community Builders is a community organization focused on provding housing and homeless services in the Central Valley of California. With a focus on service, dignity, and equity, RHCB provides community based services to the most vulnerable individuals in our community.  Position Summary  The ECM Lead Case Manager is responsible for providing direct...

  • Bilingual Lead Case Manager

    3 months ago

    Fresno, United States RH Community Builders Full time

    Job DescriptionJob DescriptionRH Community Builders is a community organization focused on provding housing and homeless services in the Central Valley of California. With a focus on service, dignity, and equity, RHCB provides community based services to the most vulnerable individuals in our community. Position Summary The ECM Lead Case Manager is...

  • Case Manager LVN

    1 month ago

    Fresno, United States Universal Healthcare MSO LLC Full time

    Job DescriptionJob DescriptionDescription:Position Summary:The Enhanced Care Management (ECM) Case Manager LVN, under the supervision of the Case Management Manager, is responsible for addressing the clinical and non-clinical needs of members with the most complex medical and social needs through systematic coordination of services and comprehensive care...

  • RN Case Manager, ED

    1 month ago

    Fresno, United States Community Health System - CA Full time

    Overview: *All positions are located in Fresno/Clovis CA*You are a nurse and a natural leader, and you're looking for a chance to join a top Case Management team as RN, Case Manager, Emergency Department. If you have passion for improving the health of the Valley and its residents, you can make a difference here, on the front lines, at the region's safety...

  • Case Manager

    4 weeks ago

    Fresno, United States Harmony Roze Staffing & Recruiting Full time

    Job DescriptionJob DescriptionFUNDAMENTAL OBJECTIVES:Under supervision, certify, recertify, review, update, and monitor family files to maintain eligibility of all program participants. This position requires an understanding of CDE Funding Terms and Conditions and the ability to apply Title 5 and corresponding regulations.ESSENTIAL JOB FUNCTIONS:Demonstrate...

  • Case Manager

    4 weeks ago

    Fresno, United States Harmony Roze Staffing & Recruiting Full time

    Job Description:FUNDAMENTAL OBJECTIVES: Under supervision, certify, recertify, review, update, and monitor family files to maintain eligibility of all program participants. This position requires an understanding of CDE Funding Terms and Conditions and the ability to apply Title 5 and corresponding regulations. ESSENTIAL JOB FUNCTIONS: Demonstrate...

  • RN Case Manager, ED

    2 months ago

    Fresno, United States Community Health System - CA Full time

    Overview: *All positions are located in Fresno/Clovis CA*You are a nurse and a natural leader, and you're looking for a chance to join a top Case Management team as RN, Case Manager, Emergency Department. If you have passion for improving the health of the Valley and its residents, you can make a difference here, on the front lines, at the region's safety...

  • RN Case Manager, ED

    2 months ago

    Fresno, United States Community Health System - CA Full time

    Overview: *All positions are located in Fresno/Clovis CA*You are a nurse and a natural leader, and you're looking for a chance to join a top Case Management team as RN, Case Manager, Emergency Department. If you have passion for improving the health of the Valley and its residents, you can make a difference here, on the front lines, at the region's safety...

  • RN Case Manager, ED

    2 months ago

    Fresno, United States Community Health System - CA Full time

    Overview: *All positions are located in Fresno/Clovis CA*You are a nurse and a natural leader, and you're looking for a chance to join a top Case Management team as RN, Case Manager, Emergency Department. If you have passion for improving the health of the Valley and its residents, you can make a difference here, on the front lines, at the region's safety...

  • Bilingual Housing Tenancy Case Manager

    5 months ago

    Fresno, United States RH Community Builders Full time

    Job DescriptionJob DescriptionRH Community Builders is a community organization focused on provding housing and homeless services in the Central Valley of California. With a focus on service, dignity, and equity, RHCB provides community based services to the most vulnerable individuals in our community. Position Summary The Housing Tenancy Case Manager...

  • Housing Case Manager

    2 months ago

    Fresno, United States Elevate Community Services Inc Full time

    Job DescriptionJob DescriptionThe Housing Case Manager is responsible for providing case management and navigation to individuals currently residing in our emergency shelter, Travel Inn. Position SummaryElevate Community Services is hiring a Housing Case Manager for the Emergency Shelters. The Housing Case Manager assists with the housing search and...

  • Child Advocate Case Manager

    1 month ago

    Fresno, United States Marjaree Mason Center Full time

    Job Type Full-time Description Type: Regular, Full-Time Benefit Eligible, M-F, 8:30am - 5:00pm FLSA: Non-Exempt Location: Fresno Pay Rate: $23.00 - $32.20/hourly (Depending on experience) Reports to: Child Advocate Program Manager SUMMARY: The Child Advocate Case Manager is responsible for working as part of a Children's Services team. The Children's...

  • Case Management Specialist III

    1 week ago

    Fresno, California, United States Turning Point of Central California Full time

    About Turning Point of Central California, Inc.Established in 1970, Turning Point of Central California, Inc. has dedicated over five decades to transforming lives throughout California. Our comprehensive services encompass Mental Health, Community Corrections, Children's Services, Housing Programs, Recovery Services, and Substance Abuse Disorders, all aimed...

  • Nurse Case Manager

    2 days ago

    Fresno, California, United States National Care Advisors Full time

    National Care Advisors - Field Nurse Case ManagerWe are seeking a highly skilled and experienced Field Nurse Case Manager to join our team at National Care Advisors. As a Field Nurse Case Manager, you will be responsible for providing case management services to special needs and eldercare clients, ensuring their quality of life and collaborating with...

  • Housing Case Manager

    1 week ago

    Fresno, United States RH Community Builders Full time $24 - $25

    Job DescriptionJob DescriptionPosition Summary The Housing Case Manager will assist clients with the development of social and community support systems to promote stability and enable clients to function at the highest level possible. The Housing Case Manager will work with clients in the rapid rehousing program and assist clients with transitioning into...