ECM Lead Care Manager

Job Description

Job Description

Salary : 25

INTRODUCTION :

Central Neighborhood Health Foundation is a Federally Qualified Healthcare Center committed

to the Triple Aim as described by the Institute for Healthcare Improvement. Improving the US

Health Care System requires simultaneous pursuit of three aims : 1) improving the experience of

care, 2) improving the health of populations and 3) reducing per capita costs of health care.

Preconditions for this include the enrollment of an identified population, a commitment to

universality for its members, and the existence of an organization (an "integrator") that accepts

responsibility for all three aims for that population.

SUMMARY :

The Enhanced Care Management program provides a whole-person approach to care that

addresses the clinical and non-clinical circumstances of high-need members enrolled in MediCal managed care. The Lead Care Manager will work with leadership, providers and managed

care to determine the needs of a high acuity, vulnerable patients. This will include providing

basic housing assistance, patient tailored intensive case-management, developing a care / service

plan; provide linkages to medical, psychiatric, social, educational and other services as needed.

The Lead Care Manager will also work with the Community Supports Program staff to provide

team-based, patient-centered care management for homeless and at-risk of homelessness

patients. The goal of the ECM program is to effectively manage high utilizers and homeless

patients during their continued care to ensure that their medical and psychosocial needs are met

and to minimize the likelihood of preventable hospital admissions and emergency department

utilization.

ESSENTIAL DUTIES AND RESPONSIBILITIES :

Conducts initial screening, assessments, and reassessments to determine the continuedneeds of the client.

Conducts outreach, enrollment, monthly reporting, and accurate completion ofcomprehensive risk assessments and care plans.

Conducts proper intake steps such as patient data collection, eligibility, programenrollment, care plan development, and assessment of needs.

Works with leadership, providers, and managed care to develop and implement patient focused care plans for clients with chronic conditions.

Provides direct care management services to ECM participants in their assigned case load in line with ECM guidelines and recommended services.

Conducts regular reviews of patients chart to ensure quality services are provided and documented by Lead Care Managers consistently and accurately.

Responds to patient inquiries and refer members to other departments, social services or support services as needed.

Works with the Housing Navigation team to ensure enrolled patients, who are experiencing homelessness or are at risk of homelessness, receive proper services.

Performs other related duties as assigned.

QUALIFICATION REQUIREMENTS :

To perform this job successfully an individual must be able to perform each essential duty,

satisfactorily. Requirements listed below are representative of the knowledge, skill and / or

abilities required. Reasonable accommodations may be made to enable individuals with

disabilities to perform the essential functions.

EDUCATION AND / OR EXPERIENCE :

Bachelors degree preferred.

Three years of experience in the health care, case management, or related field.

Knowledge and experience with Electronic Medical Records.

KNOWLEDGE, SKILLS, and ABILITIES :

Ability to communicate effectively in both written and verbal form to patients, public, medical staff, and physicians.

Excellent counseling skills and ability to relate to multi-ethnic community and varied income levels.

Strong interpersonal skills to establish productive working relationships with multidisciplinary team and support services.

Ability to work independently, collaboratively, and possess strong time management skills.

Knowledge of the Care Process and ability to apply all steps.

Knowledge of insurance coverage and the insurance eligibility process.

Knowledge of the functions and services of local community health agencies and community organizations.

Excellent organizational skills and attention to detail.