Senior Case Management Specialist

2 weeks ago

Harlingen, Texas, United States Texas Department of Aging & Disability Services Full time
Job Overview:

The Senior Case Management Specialist is responsible for executing intricate case management tasks at a senior level. This role entails overseeing case management operations for individuals at the outpatient clinic.

The position requires establishing and sustaining long-term relationships with patients, their families, and service providers to formulate comprehensive medical, social, and educational care plans.

The specialist will develop tailored care plans and assess service requirements. This role is accountable for orchestrating services and collaborating with community resources to fulfill patient needs.

Responsibilities include coordinating medical referrals, interpreter services, and various local, state, and federal programs through effective intra-agency and interagency collaboration.

The specialist ensures that all patients undergo thorough evaluations and are referred to appropriate assistance programs.

Additionally, the role involves preparing and submitting regular reports for quality assurance and performance improvement initiatives related to case management.

The Senior Case Management Specialist operates independently while seeking guidance from leadership when necessary.

Decision-making regarding patient cases is conducted with input from patients, their families, and community resources.

Supervisory responsibilities may be required as needed. The role functions under limited supervision, allowing for significant initiative and independent judgment.
Other responsibilities include participating in disaster response and recovery efforts or continuity of operations as required, which may necessitate alternate shift patterns or locations.

Key Responsibilities:

Regular attendance is expected, with potential requirements for specific or rotating shift schedules, extended hours, and overtime as per agency policies.

The specialist will deliver case management services and maintain effective communication with patients and their families promptly.

Confidentiality must be upheld, ensuring accurate documentation in the electronic medical record using the designated templates. A service log of all monthly referrals must be maintained. The specialist will manage case assignments for patients with unique needs and assist in monitoring program effectiveness and evaluation.

Options for medical care services, including benefits, referrals, and various community resources, will be provided based on individual patient requirements.

Progression of cases must be documented accurately in patients' medical records. Regular performance improvement plans and reports must be submitted to relevant departments to ensure compliance with quality management standards. Collaboration with other facilities is essential to guarantee continuity of care during patient transfers.

Interaction with patients, families, colleagues, and stakeholders should be conducted in a professional and friendly manner, providing accurate information using appropriate resources.

Timely customer service is crucial, demonstrating respect, courtesy, and a commitment to assisting patients and their families.

The specialist will function as a team member within the case management department and collaborate with other departments as necessary.

Good public relations with patient care units, hospital departments, and the community must be promoted.
The role includes overseeing patient referrals and preparing quarterly reports on findings. Outpatient referrals will be managed to ensure timely patient contact for discussions regarding referrals.

Appointments with specialists will be arranged, and reports will be obtained within the designated timeframe.

Accountability to accreditation standards is essential, with documentation requirements to meet established guidelines.

All documentation must be completed promptly to maintain compliance with accreditation standards.

Required Knowledge, Skills, and Abilities:
Comprehensive knowledge of community resources and case management principles, objectives, and methodologies.
Proficiency in using electronic medical records.
Familiarity with applicable regulations and policies.

Understanding of relevant legislative and legal practices.


Strong communication skills in both oral and written forms in English and Spanish.
Proficient in Microsoft Office applications.
Ability to manage sensitive situations with professionalism.

Competence in organizing and prioritizing tasks while interacting respectfully with diverse individuals.

Skills in data collection and analysis for quality monitoring.
Ability to assess client needs and coordinate services effectively.
Capability to monitor program outcomes and maintain confidentiality.
Ability to manage multiple projects and meet deadlines.
Independent and productive work ethic with all staff levels.
Accurate maintenance of records and reporting systems.
Proficient in preparing necessary documentation and forms.
Willingness to work beyond scheduled hours to meet objectives.

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