Case Manager
1 week ago
To Help Everyone is seeking a skilled Case Manager to lead our Enhanced Care Management Program. As a Case Manager, you will coordinate and implement organization-wide Enhanced Care Management, working cooperatively in an interdisciplinary team to provide support for members experiencing homelessness, serious mental illness/substance use disorder, and/or high medical needs.
- Engage eligible Enhanced Care Management members
- Offer services where the members live, seek care, or find most easily accessible and within health plan guidelines
- Oversee provision of Enhanced Care Management services and implementation of the Care Plan
- Connect with members via phone or in-person to facilitate engagement, assessment, follow-up, and education/training visits to develop and address the Care Plan
- Work in conjunction with members to identify Care Plan goals and objectives
- Connect members to other Community Supports / social services and supports he/she may need
- Accompany members to office visits, as needed and according to health plan guidelines
- Arrange transportation
- Responsible to convene care conference meetings
- Coordinates with Enhanced Care Management resource partners to obtain data/information to ensure accurate Care Plan updates
- Utilizes electronic tracking systems to coordinate services and input data for reporting
- Attends required Enhanced Care Management trainings
- Facilitates internal Enhanced Care Management trainings/updates to T.H.E.'s clinical and administrative staff members
- Collaborates with T.H.E.s IT department to ensure Enhanced Care Management templates are appropriate and effective at capturing needed data/information
- Reviews existing T.H.E.s protocols and polices to match Enhanced Care Management requirements
- Develops new Enhanced Care Management protocols, policies, and accompanying workflows
- Assists the required Enhanced Care Management reports and other internal reports
- Responsible for coordinating with those individuals and/or entities to ensure a seamless experience for the Member and non-duplication of services
- Advocate on behalf of Members with health care professionals
- Use motivational interviewing, trauma-informed care, and harm-reduction approaches
- Coordinate with hospital staff on discharge plan
- Accompany Member to office visits, as needed and according to T.H.E. and MCP guidelines
- Monitor treatment adherence (including medication)
- Provide health promotion and self-management training
- Other duties as assigned
Required Education and Qualifications:
- Bachelor's Degree in a healthcare, behavioral healthcare, social work, human services, or related field with one year of experience, preferably in working with patients in a clinic setting, providing home health care for patients, or social services case management services to low-income populations with one or more of the following: complex chronic conditions, high utilizer of emergency room and tertiary health care services, severe mental illness, and/or homelessness
- Licensed Vocational Nurse (LVN), licensed behavioral health care professional, social worker, substance abuse counselor, health educator, or other similar paraprofessional preferred
- MPH or related fields preferred
- Bilingual in English/Spanish (oral and written)
Knowledge, Skills and Abilities:
- Strong documentation skills
- Ability to multi-task and prioritize when needed
- Ability to independently seek out resources and work collaboratively
- Ability to develop and maintain good working relationships with staff
- Ability to use computer and learn new software programs
- Excellent interpersonal skills reflecting clarity, diplomacy, and the ability to communicate accurately and effectively with all levels of staff and management
- Demonstrates ability to work in a regulatory climate that includes oversight of state and federal entities, payer contracts etc.
- Possesses ability to communicate effectively, both verbally and in writing
- Proficient knowledge of Microsoft Outlook, MS Word, and Excel
- Able to travel and attend professional meetings, conferences, trainings, and clinic sites
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