Care Management Lead
1 month ago
Careforth is a pioneer in the caregiving space, supporting family caregivers across the United States to confidently care for their loved ones at home. Our comprehensive approach combines in-person home visits, remote coaching, and a proprietary digital collaboration app to provide caregivers with the support, guidance, and resources they need. Our commitment to excellence has earned us a reputation as an award-winning organization, dedicated to fostering a culture of trust, compassion, and continuous improvement.
Job SummaryThe Care Management Lead (CML) is a critical role within our organization, responsible for ensuring the clinical quality and compliance of our care management services. As the lead escalation point for clinical issue management and support, the CML works closely with teams to ensure compliance with documentation standards, required regulations, and best practices. This role requires a strong clinical background, excellent communication skills, and the ability to coach and mentor others.
Key Responsibilities- Respond to requests from caregivers and consumers, communicating with team members regarding concerns or emerging issues
- Track consumer risk and work with care teams to adjust the plan of care (POC) as appropriate
- Manage the case conference process, facilitating case review and discussion of risk mitigation strategies and follow-up
- Resolve and respond to complaints or grievances expressed by consumers or caregivers or their stakeholders
- Drive effective utilization of established best practices and protocols across the team, ensuring compliance with contractual obligations and NCQA accreditation requirements
- Coach and mentor care team members, identifying individual or team training needs and providing training as needed
- Assist the Manager, Care Management with incident investigations and reporting
- Ensure continuous survey and audit readiness, maintaining compliance with company policies and practices as well as federal/state/local regulations
- May supervise administrative staff
- Perform other projects and duties as assigned
- Bachelor's degree or equivalent, preferably in a health care or social services discipline
- Minimum of 4-6 years of experience in case management and care planning for older adults with complex medical conditions and/or individuals with disabilities
- Active RN license preferred
- Demonstrated ability to coach and mentor others
- Working knowledge of case management systems, community service and delivery systems, and Microsoft Office suite
- Ability to travel within assigned geographic area, with a valid driver's license and automobile insurance
- Additional state-specific qualifications may be required
Careforth is committed to creating a workplace that is inclusive, diverse, and supportive of our employees' well-being. We strive to create experiences that are accessible and welcoming to everyone, and we are dedicated to fostering a culture of continuous learning and growth. If you are passionate about caregiving and committed to excellence, we encourage you to apply for this exciting opportunity.
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