Care Coordination Specialist

2 weeks ago

Lansing, Michigan, United States OpTech Full time
Job Title: Case Manager

Why work at OpTech?
OpTech is a woman-owned organization that values your insights, fosters your development, and consistently supports you. At OpTech, you receive health and dental benefits from day one, along with opportunities for training, flexible/remote work arrangements, career advancement, a 401K plan, and competitive compensation.

RESPONSIBILITIES:
  • This role necessitates a compact nursing license to support SHS/EM/MA Fulfillment.
  • The Care Manager RN orchestrates the collaboration of a multidisciplinary team to implement a comprehensive, person-centered care management program for a diverse health plan demographic with various health and social requirements.
  • They act as the primary contact for members, caregivers, and healthcare providers, utilizing multiple communication methods such as phone calls, emails, text messages, and the online messaging platform.
  • The Care Manager RN employs the case management framework to assess, formulate, execute, monitor, and evaluate care plans aimed at enhancing the member's health throughout the care continuum.
  • They collaborate with the member, care providers, and community resources to create and execute the care plan and achieve specified objectives.
ESSENTIAL DUTIES AND RESPONSIBILITIES include the following. Other duties may be assigned:
  • Facilitate the coordination of a regionally aligned, multidisciplinary team to deliver comprehensive care that addresses member needs through telephonic and/or digital means.
  • The multidisciplinary team comprises Medical and Behavioral Health Social Workers, Registered Dietitians, Pharmacists, Clinical Support Staff, and Medical Directors.
  • Utilize the case management process to assess, design, implement, monitor, and evaluate care plans that optimize members' health across the care spectrum.
  • Evaluate the member's health, psychosocial needs, cultural preferences, and support systems.
  • Engage the member and/or caregiver to formulate a personalized care plan, tackle barriers, identify care gaps, and promote enhanced overall health outcomes.
  • Arrange necessary resources to meet identified needs (e.g., community resources, mental health services, substance abuse services, financial support services, and disease-specific services).
  • Coordinate care delivery and support among member support systems, including providers, community-based organizations, and family.
  • Advocate for members and encourage self-advocacy.
  • Provide education that encompasses health literacy, self-management skills, medication plans, and nutrition.
  • Monitor and assess the effectiveness of the care management plan, ensuring adherence to the care plan to track progress toward goals and adjust as necessary.
  • Accurately document interactions that facilitate member management.
  • Prepare the member and/or caregiver for discharge from a facility to home or for transfer to another healthcare facility to ensure continuity of care.
  • Educate the member and/or caregiver about post-transition care and necessary follow-up, summarizing the events during an episode of care.
  • Secure durable medical equipment and transportation services, communicating this to the member and/or caregiver and relevant individuals at the receiving facility or home care agency.
  • Adhere to professional standards as outlined by protocols, rules, and guidelines while meeting quality and production goals.
  • Engage in professional development by completing relevant continuing education and maintaining Certified Case Manager (CCM) status.
QUALIFICATIONS:
  • To succeed in this role, an individual must be able to perform each essential duty satisfactorily.
  • The requirements listed below represent the knowledge, skill, and/or ability required.
  • Reasonable accommodations may be made to enable individuals with disabilities to perform essential functions.
OTHER SKILLS AND ABILITIES:
  • Ability to think critically, make decisions, and solve problems on various topics that can influence member outcomes.
  • Empathetic, supportive, and an attentive listener.
  • Proficient in motivational interviewing techniques.
  • Demonstrated time management capabilities.
  • Organizational skills with the ability to manage multiple systems/tools while simultaneously interacting with a member.
  • Intermediate computer knowledge, typing proficiency, and familiarity with Microsoft programs (Excel, OneNote, Outlook, Teams, Word, etc.) are essential.
  • Must value teamwork but also be capable of working independently.
  • Excellent interpersonal and communication skills, both written and verbal.
EDUCATION AND EXPERIENCE:
  • Nursing Diploma or Associate's degree in nursing is required.
  • A Bachelor's degree in nursing is strongly preferred.
  • A minimum of 3 years of clinical nursing experience in clinical, acute/post-acute care, and community settings is required.
  • At least 1 year of case management experience in a managed care environment is strongly preferred.
  • Experience managing patients through telephonic and digital channels (mobile applications and messaging) is preferred.
CERTIFICATES, LICENSES, REGISTRATIONS:
  • This role necessitates a compact nursing license to support SHS/EM/MA Fulfillment.
  • Current, active, and unrestricted Michigan Registered Nurse license is required.
  • Certification in Case Management (CCM) is required or must be obtained within 18 months of hire.
  • Certification in Chronic Care Professional (CCP) is preferred.
OpTech is an equal opportunity employer committed to fostering a diverse environment. All qualified applicants will receive consideration for employment without regard to race, color, religion, gender, gender identity or expression, sexual orientation, national origin, genetics, pregnancy, status as a parent, disability, age, veteran status, or other characteristics as defined by federal, state, or local laws.

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