Care Manager-Care Management

Job Description

Job Description

Job Summary :

Care Management is a service model whereby all of an individual's caregivers communicate and interface so that the member's needs are addressed in a comprehensive manner. This is done primarily through a "care manager" who oversees and provides access to all of the services an individual needs to assure that they receive everything necessary to prevent hospitalizations, stay healthy, and maintain stability.

The Care Manager is ultimately responsible for the overall provision and coordination of services to assigned caseload. The Care Manager guides program enrollees and their caretakers (legal guardians) through the health care system by assisting with access issues, developing relationships with service providers, and tracking interventions and outcomes.

Job Responsibilities :

• Obtains required Care Management enrollment consents from the individual or legal guardian
• Completes initial and ongoing needs assessments (Child and Adolescent Needs and Strengths; CANS) to determine the individual’s most appropriate level of care management
• Responsible for the development and overall management of the patient’s Individualized Plan of Care.
• Support adherence to treatment recommendations
• Monitor and evaluate a patient’s needs, including prevention, wellness, medical, mental health, care transitions, and social and community services where appropriate
• Meets client monthly contact and billing requirements
• Meets Care Management documentation requirements in a timely and accurate manner by effectively utilizing designated Care Management Portal and Electronic Health Records (EHRs)
• Functions as an advocate for clients within the agency and external service providers
• Promotes wellness and prevention by linking enrollees with resources and services based on their individual needs and preferences
• Educate the child / caregiver on care of chronic conditions, immunization, screening and other preventive interventions
• Helps clients to obtain and maintain public benefits necessary to gain health care services, including Medicaid and cash assistance eligibility, Social Security, SNAP, housing, legal services, employment and training supports, and others
• Effectively communicates and shares information with the individual and their families and other caregivers with appropriate consideration for language, literacy and cultural preferences
• Conducts care planning meetings / conferences and serves as an interdisciplinary team member to effectively provide / coordinate comprehensive and holistic care
• Identifies available community-based resources and actively manages appropriate referrals, access, engagement, follow-up and coordination of services
• In the event of hospital admissions, actively engages in the discharge planning process ensuring that the patient has all recommended post discharge services in place prior to discharge
• Attends and participates in ongoing staff development trainings to enhance skills needed to effectively meet the demands of the Care Manager position
• Ensure that child has periodic evaluations and follow up treatment for dental, vision and hearing care, following Medicaid EPSDT guidelines
• Other duties as assigned

Qualifications

Supervisory Responsibility

No

Work Environment : Normal

Position Type / Expected Hours of Work :

M-F 9-5, but hours may need to be flexed for some evening or early morning appointments

Travel (if required) :

Ability to work in the field and make visits to people supported homes, hospital visits, school, etc. Via public transportation or personal vehicle.

Physical Requirements :

Ability to walk 5 blocks, ability to climb stairs

Other Duties :

Please note this job description is not designed to cover or contain a comprehensive listing of activities, duties or responsibilities that are required of the employee for this job. Duties, responsibilities and activities may change at any time with or without notice.

EQUAL EMPLOYMENT OPPORTUNITY STATEMENT

It is the policy of Rising Ground that the Agency wholly complies with equal treatment of all employees and applicants for employment without unlawful discrimination as to an individual’s perceived or actual race, creed, color, national origin, alienate, citizenship status, gender, age, disability, marital status, partnership status, sexual orientation, ethnicity, religion, or veteran status in all employment decisions, including but not limited to recruitment, hiring, compensation, training and apprenticeship, promotion, upgrading, demotion, downgrading, transfer, layoff and termination and all other terms and conditions of employment.