Job Description :
Healthcare - Case Manager II
Remote
3 months
Job Description: 100% remote - must work PST hours.
Candidates with previous experience with the same client are highly preferred, If they are licensed it must be in CA.
Description
Job Summary
Healthcare Services (HCS) works with members, providers and multidisciplinary team members to assess, facilitate, plan and coordinate an integrated delivery of care across the continuum, including behavioral health and long term care, for members with high need potential.
HCS staff work to ensure that patients progress toward desired outcomes with quality care that is medically appropriate and cost-effective based on the severity of illness and the site of service.
Knowledge/ Skills/ Abilities
Completes clinical assessments of members per regulated timelines and determines who may qualify for case management based on clinical judgment, changes in member's health or psychosocial wellness, and triggers from the assessment.
Develops and implements a case management plan in collaboration with the member, caregiver, physician and/or other appropriate healthcare professionals and member's support network to address the member needs and goals.
Conducts telephonic, face-to-face or home visits as required.
Performs ongoing monitoring of the care plan to evaluate effectiveness, document interventions and goal achievement, and suggest changes accordingly.
Maintains ongoing member case load for regular outreach and management.
Promotes integration of services for members including behavioral health care and long term services and supports to enhance the continuity of care for members.
May implement specific wellness programs i.e. asthma and depression disease management.
Facilitates interdisciplinary care team meetings and informal ICT collaboration.
Uses motivational interviewing and clinical guideposts to educate, support and motivate change during member contacts.
Assesses for barriers to care, provides care coordination and assistance to member to address concerns.
Collaborates with RN case managers/supervisors as needed or required
Case managers in Behavioral Health and Social Science fields may provide consultation, resources and recommendations to peers as needed
QUALIFICATIONS
REQUIRED EDUCATION:
Any of the following:
Completion of an accredited Licensed Vocational Nurse (LVN) or Licensed Practical Nurse (LPN) Program OR Bachelor's or Master's Degree (preferably in a social science, psychology, gerontology, public health or social work or related REQUIRED
EXPERIENCE: 1-3 years in case management, disease management, managed care or medical or behavioral health settings.
REQUIRED LICENSE, CERTIFICATION, ASSOCIATION: If license required for the job, license must be active, unrestricted and in good standing.
PREFERRED EXPERIENCE: 3-5 years in case management, disease management, managed care or medical or behavioral health settings.
PREFERRED LICENSE, CERTIFICATION, ASSOCIATION:
Any of the following:
Licensed Clinical Social Worker (LCSW), Advanced Practice Social Worker (APSW), Certified Case Manager (CCM), Certified in Health Education and Promotion (CHEP), Licensed Professional Counselor (LPC/LPCC), Respiratory Therapist, or Licensed Marriage and Family Therapist (LMFT).