Address
Form of workRemote Opportunity
Lead Care Manager
Work hours: Must be able to work between the hours of 8:30 -5pm Pacific Time
Position overview:
Under the direction of the Director of Enhanced Care Management and/or ECM Program Manager, the Lead Care Manager serves as the client’s primary point of contact and works with all their providers such as doctors, specialists, pharmacists, social services providers, and others to make sure everyone is in agreement about the client’s needs and care. The LCM manages client cases, coordinates health care benefits, provides education and facilitates member access to care in a timely and cost-effective manner. The LCM collaborates and communicates with client’s caregivers/family support persons, other providers and others in the Care Team in order to promote wellness, recovery, independence, resilience, and member empowerment, while ensuring access to appropriate services and maximizing member benefit.
Education, Experience, and Credentialing:
Bachelor’s degree in Social Work preferred
Qualifying experience - previous experience with providing Case Management Services and/or care coordination for vulnerable and/or underserved and diverse populations
Must act in accordance with all Health Insurance Portability and Accountability Act (HIPAA) of 1996 and related State Law, confidential requirements. Must have successfully completed HIPAA training, pass the HIPAA tes, and receive the Certification of
Compliance.
Bilingual ability is a plus.
Essential Job Duties/ Responsibilities:
- Remote [technical] care management duties performed through HIPAA-compliant hardware and software:
- Assess member needs in the areas of physical health, mental health, SUD, oral health, palliative care, memory care, trauma-informed care, social supports, housing, and referral and linkage to community-based services and supports
- Oversees the development of the client care plans and goal settings
- Offer services where the member resides, seeks care, or finds most easily accessible, including office-based, telehealth, or field-based services
- Connect clients to other social services and supports that are needed
- Advocate on behalf of the client with health care professionals (e.g. PCP, etc.)
- Utilize evidence-based practices, such as Motivational Interviewing, Harm Reduction, and Trauma-Informed Care principles
- Conduct outreach and engagement activities in order to facilitate linkage to the ECM program and log activity in the Client Relationship Management (CRM) system
- Evaluate client’s progress and update SMART goals
- Provide mental health promotion
- Arrange transportation (e.g., ACCESS)
- Complete all documentation, including outcome measures within the timeframes established by the individual care plans
- Maintain up-to-date patient health records in the Electronic Medical Record (EMR) system and other business systems
- Complete monthly reporting to ensure program compliance
- Attend training as assigned
