Talent.com
Case Manager I

Case Manager I

CHPWSeattle, WA, United States
30+ days ago
Job type
  • Part-time
Job description

This position is available remotely in Washington State.

Who we are

Community Health Plan of Washington is

an equal opportunity employer committed to a diverse and inclusive workforce. All qualified applicants will receive consideration for employment without regard to any actual or perceived protected characteristic or other unlawful consideration.

Our commitment is to :

  • Strive to apply an equity

lens to all our work.

  • Reduce health disparities.
  • Become an anti-racist organization
  • Create an equitable
  • work environment.

    About the Role

    Responsible for the operational delivery of the plan's case management and coordination programs and processes. Provides case management services for CHPW members with short term, long term, stable, unstable, and predictable course of illness, and / or highly complex medical / behavioral and social conditions.

    The goal is to improve members' quality of life and ensure cost-effective outcomes by using internal and community-based resources.

    The Case Manager level will be determined by the hiring manager based on education, previous experience, and demonstrated leadership skills.

    To be successful in this role, you :

  • Have a Bachelor's degree in nursing, or a master's degree in social work and / or related behavior health field (preferred)
  • Possess Current, unrestricted license in the State of Washington as a registered nurse (RN) (required) OR
  • Current, unrestricted license in the State of Washington as a Social Worker (LSWAA, LSWAIC) (required), OR
  • Current, unrestricted license in the State of Washington as a Mental Health Counselor (LMHC), Mental Health Professional (LMHP), or Marriage and Family Therapist (LMFT) (required)
  • Have a minimum of one (1) year case management, home health or discharge planning experience; or a combination of education and experience which provides an equivalent background required OR
  • Have a minimum of one (1) year facility-based medical or behavioral health experience and / or outpatient psychiatric and substance abuse / substance abuse disorder treatment experience, required; or equivalent combination of education and experience and / or working with children and families. Experience with those who have disabilities and knowledge of Child and Families Services
  • Have a minimum three (3) years of clinical experience in an acute care and / or outpatient setting (required)
  • Experience and proficiency with Microsoft Office products
  • Possess a Case Management Certification (preferred)
  • Have Bilingual abilities (preferred)
  • Essential functions and Roles and Responsibilities :

    The Case Manager I is responsible for performing telephonic case management for members with acute, chronic, and complex needs.

    Examples listed below are not necessarily exhaustive and may be revised by the employer.

  • Advocates on behalf of members and facilitates coordination of resources required to help members reach optimum functional levels and autonomy within the constraints of their disease conditions.
  • Works within a multi-functional team to connect with providers, members, caregivers, contracted vendors, community resources, and health plan partners to assess the member's health status, identify care needs and ensure access to appropriate services to achieve positive health outcomes.
  • Assesses, evaluates, plans, implements, and documents care of members within the organization's clinical database system, in accordance with organizational policies and procedures.
  • Responsible for the assessment of members, including identifying and coordinating access to the appropriate level of care and treatment. Uses the assessment information to assign the appropriate risk and complexity level, and create and document a care plan in coordination with the member, family and health team input.
  • Initiates a plan of care based on member-specific needs, assessment data and the medical / behavioral plan of care. Goals for members are measurable and developed in conjunction with the patient / family to improve quality of life.
  • Plans care in collaboration with members of the multidisciplinary team, and considers the physical, behavioral, cultural, psychosocial, spiritual, age specific and educational needs of the member in the plan of care.
  • Reviews and revises the plan of care with the interdisciplinary care team to reflect changing member needs based on evaluation of the members' status, and / or as a result of reassessment.
  • Implements the plan of care through direct member care, coordination, and delegation of the activities of the health care team. Promotes continuity of care by accurately and completely communicating to health care team the status of members for whom care is provided. Engages community resources where applicable.
  • Conducts interdisciplinary care team meetings with the member / family to assess care plan and recommend adjustments as indicated.
  • Continuously evaluate members' progress towards goals, identify potential barriers to attaining goals and expected outcomes in collaboration with other health care team members.
  • Documents all case activity using the CHPW care management system and follows documentation standards and protocols.
  • Collaborates with the Transition of Care (TOC) team if a member is hospitalized.
  • Serves as a liaison at various local and statewide meetings and / or workgroups and provides clinical support to providers' network to enhance integrated care coordination.
  • Assesses barriers to care and assist members and health care team to address concerns.
  • Implements developed workflow activities and activities for designated programs.
  • Conduct member case management in the field at Provider(s) office, member's home, inpatient medical or psychiatric hospitals, skilled nursing facilities, adult family homes, or in a community setting.
  • Attend member appointments or care conferences in-person in collaboration with the members care team when indicated.
  • This position may require traveling on behalf of the Company and working in the field. It is required that a current driver's license, proof of insurance and an acceptable driving record are maintained.
  • Employees are expected to report to work as scheduled, participate in all assigned meetings, and meet established performance and accountability standards.
  • Other duties as assigned. Essential functions listed are not necessarily exhaustive and may be revised by the employer, at its sole discretion.
  • Knowledge, Skills, and Abilities :

  • Managed care (Medicaid and / or Medicare) experience
  • Previous experience using Care Management software applications
  • Knowledge of, and experience with, community resources preferred
  • Knowledge of Medicare and Medicaid regulations
  • Experience in care management workflow systems
  • Effective verbal and written communication skills
  • Strong organizational, time management, and project management skills
  • Ability to work independently
  • Comfortable presenting in a group setting
  • Perform all functions of the job with accuracy, attention to detail and within established timeframes.
  • Meet attendance and punctuality standards

    As part of our hiring process, the following criteria must be met :

  • Complete and successfully pass a criminal background check
  • Criminal History : includes review of criminal convictions and probation. CHPW does not automatically or categorically exclude persons with a criminal background from employment. The applicant's criminal history will be reviewed on a case-by-case basis considering the risk to the business, members, and / employees.

  • Has not been sanctioned or excluded from participation in federal or state healthcare programs by a federal or state law enforcement, regulatory, or licensing agency
  • Vaccination requirement (CHPW offers a process for medical or religious exemptions)
  • Candidates whose disabilities make them unable to meet these requirements are considered fully qualified if they can perform the essential functions of the job with reasonable accommodation.
  • Compensation and Benefits :

    The position is FLSA Exempt and is not eligible for overtime. Based on market data, this position grade is 66E and has a 10% annual incentive target based on company, department, and individual performance goals.

    CHPW offers the following benefits for Full and Part-time employees and their dependents :

  • Medical, Prescription, Dental, and Vision
  • Telehealth app
  • Flexible Spending Accounts, Health Savings Accounts
  • Basic Life AD&D, Short and Long-Term Disability
  • Voluntary Life, Critical Care, and Long-Term Care Insurance
  • 401(k) Retirement and generous employer match
  • Employee Assistance Program and Mental Fitness app
  • Financial Coaching, Identity Theft Protection
  • Time off including PTO accrual starting at 17 days per year
  • 40 hours Community Service volunteer time
  • 10 standard holidays, 2 floating holidays
  • Compassion time off, jury duty
  • Sensory / Physical / Mental Requirements :

    Sensory

    Speaking, hearing, near vision, far vision, depth perception, peripheral vision, touch, smell, and balance.

    Physical

  • Extended periods of sitting, computer use, talking, and possibly standing
  • Simple grasp, firm grasp, fine manipulation, pinch, finger dexterity, supination / pronation, wrist flexion
  • Mental :

    Frequent decision-making.

    Work Environment :

    Office environment Employees who frequently work in front of computer monitors are at risk for environmental exposure to low-grade radiation.

    Equal Opportunity Employer / Protected Veterans / Individuals with Disabilities

    This employer is required to notify all applicants of their rights pursuant to federal employment laws. For further information, please review the Know Your Rights notice from the Department of Labor.

    Create a job alert for this search

    Case Manager • Seattle, WA, United States

    Related jobs
    • Promoted
    Case Manager II - Mental Health 267

    Case Manager II - Mental Health 267

    Telecare CorporationTukwila, WA, United States
    Full-time
    They made it easier for me to live, breathe, eat, and stay clean.Without them, I'd be waiting somewhere, waiting for someone to give me a chance to live. What You Will Do to Change Lives.Under direc...Show moreLast updated: 30+ days ago
    • Promoted
    Case Manager

    Case Manager

    Premera Blue CrossMountlake Terrace, WA, United States
    Temporary
    Join Our Team : Do Meaningful Work and Improve People's Lives.Our purpose, to improve customers' lives by making healthcare work better, is far from ordinary. Working at Premera means you have the op...Show moreLast updated: 30+ days ago
    • Promoted
    Manager, Case Management

    Manager, Case Management

    Premera Blue CrossSeattle, WA, US
    Full-time
    Join Our Team : Do Meaningful Work and Improve People's Lives.Our purpose, to improve customers' lives by making healthcare work better, is far from ordinary. Working at Premera means you have the op...Show moreLast updated: 3 days ago
    • Promoted
    Technical Case Manager II

    Technical Case Manager II

    Henry ScheinSeattle, WA, United States
    Full-time
    This position is responsible to act as the primary customer service liaison between the customer and the company and lead all efforts required for resolution of highly complex and escalated issues....Show moreLast updated: 30+ days ago
    • Promoted
    Case Manager | SUDP | Behavioral Health | Bellevue, WA

    Case Manager | SUDP | Behavioral Health | Bellevue, WA

    Hotel California by the SeaBellevue, WA, US
    Full-time
    Hotel California by the Sea (HCBTS) is a dual-diagnosis drug and alcohol treatment center located in Bellevue, WA with other facilities located in Newport Beach, CA and Cincinnati, OH.We are commit...Show moreLast updated: 30+ days ago
    • Promoted
    Travel Registered Nurse (RN) - Case Manager - $2,833 per week in Everett, WA

    Travel Registered Nurse (RN) - Case Manager - $2,833 per week in Everett, WA

    TravelNurseSourceEverett, WA, US
    Full-time +1
    TravelNurseSource is working with Lancesoft Inc to find a qualified Case Manager RN in Everett, Washington, 98201!.Minimum 1 year of experience required. Established in 2000, LanceSoft is a Certifie...Show moreLast updated: 14 days ago
    • Promoted
    Travel RN Case Manager

    Travel RN Case Manager

    BesticaEverett, WA, US
    Full-time
    Bestica is seeking a travel nurse RN Case Management for a travel nursing job in Everett, Washington.Job Description & Requirements. Will this traveler need to float between like units : Yes, bas...Show moreLast updated: 30+ days ago
    • Promoted
    Case Manager II - Mental Health 262

    Case Manager II - Mental Health 262

    Telecare CorporationTacoma, WA, United States
    Full-time +1
    What You Will Do to Change Lives.Under direct supervision, the Case Manager II serves as a primary support and case manager for individuals with mental illness and other co-occurring disorders by a...Show moreLast updated: 30+ days ago
    • Promoted
    Travel Registered Nurse (RN) - Case Manager - $2,793 per week in Everett, WA

    Travel Registered Nurse (RN) - Case Manager - $2,793 per week in Everett, WA

    TravelNurseSourceTacoma, Washington, US
    Full-time +1
    TravelNurseSource is working with Lancesoft Inc to find a qualified Case Manager RN in Everett, Washington, 98201!.Minimum 1 year of experience required. Certifications and License required : -.Establ...Show moreLast updated: 14 days ago
    • Promoted
    • New!
    Case Manager- 3 openings

    Case Manager- 3 openings

    HopelinkBellevue, WA, United States
    Full-time +1
    Location : North and East King County (Bothell, Kenmore, Redmond, Bellevue).Work Schedule : Full Time, 40 hours a week, Typically Monday - Friday 8 : 30am - 5pm or 9 : 30am-5 : 30pm(flex).The initial 2-wee...Show moreLast updated: 8 hours ago
    • Promoted
    Travel Registered Nurse (RN) - Case Manager - $2,414 per week in Tacoma, WA

    Travel Registered Nurse (RN) - Case Manager - $2,414 per week in Tacoma, WA

    TravelNurseSourceTacoma, WA, US
    Full-time
    TravelNurseSource is working with GetMed Staffing to find a qualified Case Manager RN in Tacoma, Washington, 98405!.GetMed Staffing is searching for a strong Case Manager RN to assist our traveler-...Show moreLast updated: 14 days ago
    • Promoted
    Travel Acute Care RN Case Manager

    Travel Acute Care RN Case Manager

    Host HealthcareTacoma, WA, US
    Full-time
    Host Healthcare is seeking a travel nurse RN Case Management for a travel nursing job in Tacoma, Washington.Job Description & Requirements. Pay package is based on 8 hour shifts and 40 hours per...Show moreLast updated: 18 days ago
    • Promoted
    Travel Acute Care RN Case Manager

    Travel Acute Care RN Case Manager

    American TravelerTacoma, WA, US
    Full-time
    American Traveler is seeking a travel nurse RN Case Management for a travel nursing job in Tacoma, Washington.Job Description & Requirements. American Traveler is seeking an experienced RN for a...Show moreLast updated: 18 days ago
    • Promoted
    Case Manager - Transitional Living

    Case Manager - Transitional Living

    Friends of YouthKirkland, WA, US
    Full-time +1
    The Case Manager of Transitional Living provides comprehensive case management services to a caseload of youth, young adults, and pregnant or parenting youth ages 16-21 who are receiving transition...Show moreLast updated: 1 day ago
    • Promoted
    Case Manager

    Case Manager

    Smokey Point Behavioral HospitalMarysville, WA, United States
    Full-time
    Smokey Point Behavioral Hospital - Marysville, WA.JOIN OUR TEAM AS A CASE MANAGER!.How will you make a difference?.We are seeking a compassionate and dedicated individual to join our team as a Case...Show moreLast updated: 30+ days ago
    • Promoted
    Travel Nurse - RN - Case Manager - $2633 / Week

    Travel Nurse - RN - Case Manager - $2633 / Week

    Coast Medical ServiceEverett, WA, US
    Full-time
    Coast Medical Service is seeking an experienced Case Manager Registered Nurse for an exciting Travel Nursing job in Everett, WA. Shift : 4x10 hr days Start Date : ASAP Duration : 13 weeks Pay : $2633 / ...Show moreLast updated: 30+ days ago
    • Promoted
    Travel RN Case Manager

    Travel RN Case Manager

    Fusion Medical StaffingTacoma, WA, US
    Full-time
    Facility in Tacoma, Washington.Fusion Medical Staffing is seeking a Case Manager RN for a 14-week travel assignment in Tacoma, Washington. As a member of our team, you'll have the opportunity to mak...Show moreLast updated: 1 day ago
    • Promoted
    • New!
    Case Manager - Renton

    Case Manager - Renton

    Evergreen Treatment ServicesRenton, WA, United States
    Full-time
    Location - South King County Clinic - Renton, WA.Schedule - Monday - Friday, 5 : 30 am to 2 pm.ETS strives to achieve pay equity and transparency as part of our goal to create an equitable workplace....Show moreLast updated: 8 hours ago