Care Manager
1 month ago
Care Management is a vital service model that ensures seamless communication and coordination among all caregivers involved in a resident's care. A designated Care Manager takes the lead, overseeing and providing access to the necessary services to address the resident's needs, preventing hospitalizations, maintaining health, and ensuring stability.
The Care Manager is responsible for providing and coordinating services for their assigned caseload. This involves guiding program enrollees and their legal guardians through the healthcare system, addressing access issues, building relationships with service providers, and monitoring interventions and outcomes.
Key Responsibilities:
- Obtain required Care Management enrollment consent from individuals or legal guardians.
- Conduct initial and ongoing needs assessments (Child and Adolescent Needs and Strengths; CANS) to determine the most appropriate level of care management.
- Manage the patient's Individualized Plan of Care, coordinating services, supporting treatment adherence, and monitoring various needs, including prevention, wellness, medical mental health, care transitions, and social and community services.
- Meet client contact requirements, including face-to-face visits based on acuity levels.
- Fulfill Care Management documentation requirements using designated tools like Medicaid Analytics Performance Portal (MAPP) and Electronic Health Records (EHRs).
- Serve as an advocate for clients within the agency and with external service providers.
- Promote wellness and prevention by connecting enrollees with resources based on individual needs and preferences.
- Educate children/caregivers on the care of chronic conditions, immunization, screening, and preventive interventions.
- Assist clients in obtaining and maintaining public benefits essential for healthcare services.
- Effectively communicate and share information with individuals, families, and other caregivers, considering language, literacy, and cultural preferences.
- Conduct care planning meetings/conferences and serve as an interdisciplinary team member for comprehensive and holistic care.
- Identify available community-based resources and actively manage referrals, access, engagement, follow-up, and service coordination.
- Engage in discharge planning for hospital admissions, ensuring recommended post-discharge services are in place.
- Attend ongoing staff development training to enhance Care Manager skills.
- Ensure periodic evaluations and follow-up treatment for dental, vision, and hearing care per Medicaid EPSDT guidelines.
- Perform other duties as assigned by the Care Management Agency.
Requirements:
- Associate Degree with two years' experience.
- Bachelor of Arts or Science with two years' experience.
- Registered Nurse or Licensed Practical Nurse with two years' experience.
- Master's Degree in a related field (License preferred).
Preferred Skills:
- Bilingual in Spanish is a plus.
- Proficiency in computer software packages (MS Word, Excel, Outlook, etc.).
- Excellent oral and written communication skills.
- Problem-solving solid capability and capacity to meet multiple deadlines under pressure.
- Highly organized and detail-oriented.
- Relevant expertise and experience in serving children and families in child welfare, developmental disabilities, mental health, healthcare, and/or other systems, as well as those receiving preventive services.
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