Case Manager

Job Title: Case Manager

Department: IDD/SMI

Reports To: Program Manager

FLSA Status: Exempt

$3000 Sign on Bonus

Summary:

Under the direction of the supervisor of the division assigned, the case manager works to directly provide high quality care to NSO clients by assessing, coordinating, planning, and implementing client centered care plan to achieve positive outcomes; coordinate the interdisciplinary care team (IDT) by connecting members of the team to ensure clients services and benefits are maximized while improving client satisfaction, compliance with treatment regimen, medication adherence, access to benefits, stable housing, referrals, entitlements, and reducing ER utilization, inpatient admissions, and overall cost of care.

Requirements and Duties:

• Completes case management workflow per identified process and documents timely within the electronic medical record within policy identified timeframes.

• Assesses referrals to identify patient/significant others' needs, level of intensity, insurance benefits and other patient resources.

• Make in-person face -to-face encounters (visits) in the clients home, office, or virtual calls to assess members current health status and engage client
• Completes all documentation including required assessments, case plans or IPOS, within required time frames, per policy and procedure.
• Collaborates with appropriate key individuals to participate in the case plan or IPOS process and continues to involve and communicate as needed to ensure best possible outcomes for client.
• Identifies gaps or barriers in the case plan or IPOS treatment plans
• Initiates patient focused case plan or IPOS, coordinating services, appointments and care within required time frames and as needed
• Make appropriate client centered referrals to outside sources as needed to resolve barriers to access, social determinants of health or benefits
• Assesses the educational needs of clients, families and members of the health care team and provides, develops and implements appropriate teaching strategies or makes appropriate referrals.
• Provides client education to assist with self-management as needed based on case plan or IPOS; and delivers clinical support to members across a wide array of health topics and conditions

• Provides ongoing monitoring of clients progress toward treatment goals and objectives via ongoing face to face contact as directed by the Person-Centered Plan of Service

• Promotes high-quality care through adherence to quality standards for documentation, case management process and client satisfaction

• Collaborates with specialists, physicians, and medical/clinical directors (for both physical, behavioral health and substance abuse) to coordinate inter-disciplinary care team, and attends any necessary on or off-site meetings to ensure patients care is seamless
• Reviews reporting for trends and data in compliance, medication adherence, outreach failures, er utilization, and/ but not limited to inpatient admissions, and provides ongoing monitoring of client
• Ensures client is compliant with treatment plan, provider visits and medication regimen; fosters and promotes self-care management and independence in the client's care.
• Facilitates and supports client compliance with appointments with provider, clinic, and therapist interactions as needed
• Maintain compliance with all company policies and procedures and applicable rules and regulations of MDHHS, DWHIN, NSO, and any other entity NSO has entered into a partnership or contracted agreement.
• Coordinate with clients to ensure the correct identified resources are recommended or obtained within the client's qualifying benefits or entitlement services
• Consults when appropriate to ensure adequate client caseloads

Required Qualifications:

• A bachelor's degree in a Human Services Field
• 2 or more years of community based in mental health as a case manager
• 1+ years of recent experience with a mental health/behavioral health clinical experience
• Roles that are interfacing with our children, adolescent, and teen population will require a total of 3 years working with minors or 24 hours of child-specific training (CEUs) to be certified by CMHP for MDHHS qualified provider.
• Excellent typing skills and ability to navigate a Windows based environment, experience in the use and navigation of an electronic medical record (EMR)
• Ability to navigate through an electronic medical record (EMR) and utilize Microsoft Products such as Outlook, Teams, Word, and Excel.
• Access to secure, high-speed internet and a dedicated, ability to work remote or within a hybrid role, with ability to protect health information and maintain HIPAA
• New Graduates in Social work are welcome. Limited Licensures candidates, candidates will need to be eligible to sit for licensure and pass within 24 months of employment social work, or a minimum of (5) eligible limited licensure renewals.

Preferred Qualifications:

• Limited Licensed Social Worker (LLBSW or LLMSW), Licensed Social Worker (LBSW or LMSW),
• Certified Case Manager (CCM) OR the ability to obtain certification within 24 months of employment
• Background in community-based care, mental health, behavioral health, homecare, or managed care case management
• Experience/ knowledge of discharge planning, resolving disparities in health care, urban populations, atypical home settings, and court ordered mental health care
• Experience in utilization review, concurrent review, or coding
• Experience in removing gaps in care, barriers or/ other disparities in healthcare

Hybrid Work Policy:

This position offers a hybrid work schedule contingent on meeting productivity standards established by leadership and may be adjusted at any time based on the agency's needs. Employees may work remotely for a portion of their schedule; however, hybrid work does not permit full days working from home if clients are requesting in-person appointments in the office or community. Staff are expected to be flexible and prioritize client needs, ensuring timely and appropriate service delivery.

During the first 30 days of employment, staff are required to work in the office. This period may be extended based on performance.

DISCLAIMER MESSAGE: The above elements are intended to describe the general nature and level of work being performed by people assigned to this classification. They are not intended to be construed as an exhaustive list of all responsibilities and duties of personnel so classified, or a contractual commitment, and NSO retains the right to amend or revise this job description at any time.

NSO is an Equal Opportunity Employer and is committed to excellence through diversity and considers candidates without regard to sex (including pregnancy related conditions) genetic information, race, color, weight, height, religion, nation origin, citizenship, age, disability, martial or veteran status, misdemeanor arrest record, sexual orientation, transgender status or gender identity or any other legally protected status