Community Based Care Manager

Community Based Care Manager

HealthCare Support is actively seeking a Community Based Care Manager to fill an opening with a healthcare provider in Detroit, MI.

Daily Responsibilities for Community Based Care Manager:

• Engage the member and their natural support system through strength-based assessments and a trauma-informed care approach using motivation interviewing to complete health and psychosocial assessments through a health equity lens unique to the needs of each member that identify the cultural, linguistic, social and environmental factors/determinants that shape health and improve health disparities and access to public and community health frameworks
• Facilitate regularly scheduled inter-disciplinary care team (ICT) meetings to meet the needs of the member
• Engage with the member to establish an effective, professional relationship via telephonic or electronic communication
• Develop a person-centered individualized care plan (ICP) in collaboration with the ICT, based on member’s desires, needs and preferences
• Identify and manage barriers to achievement of care plan goals
• Identify and implement effective interventions based on clinical standards and best practices
• Assist with empowering the member to manage and improve their health, wellness, safety, adaptation, and self-care through effective care coordination and case management
• Facilitate coordination, communication and collaboration with the member the ICT in order to achieve goals and maximize positive member outcomes
• Educate the member/ natural supports about treatment options, community resources, insurance benefits, etc. so that timely and informed decisions can be made
• Employ ongoing assessment and documentation to evaluate the member’s response to and progress on the ICP
• Evaluate member satisfaction through open communication and monitoring of concerns or issues
• Monitors and promotes effective utilization of healthcare resources through clinical variance and benefits management
• Verify eligibility, previous enrollment history, demographics and current health status of each member
• Completes psychosocial and behavioral assessments by gathering information from the member, family, provider and other stakeholders
• Oversee (point of contact) timely psychosocial and behavioral assessments and the care planning and execution of meeting member needs
• Participate in meetings with providers to inform them of Care Management services and benefits available to members
• Assists with ICDS model of care orientation and training of both facility and community providers
• Identify and address gaps in care and access
• Collaborate with facility based case managers and providers to plan for post-discharge care needs or facilitate transition to an appropriate level of care in a timely and cost-effective manner
• Coordinate with community-based case managers and other service providers to ensure coordination and avoid duplication of services
• Appropriately terminate care coordination services based upon established case closure guidelines for members not enrolled in contractually required on going care coordination.
• Provide clinical oversight and direction to unlicensed team members as appropriate
• Document care coordination activities and member response in a timely manner according to standards of practice and our company policies regarding professional documentation
• Continuously assess for areas to improve the process to make the members’ experience with our company easier and shares with leadership to make it a standard, repeatable process
• Adherence to NCQA standards (CMSA standards below)
• Perform any other job duties as requested
• Location: Detroit Michigan Area – This will be a mobile position, the ideal candidate should reside in either Wayne or Macomb counties. *These are member facing positions; flu vaccinations will be required if hired.
   

Required Qualifications for Community Based Care Manager:
Education and Experience:

• Current unrestricted clinical license in state of practice as a Registered Nurse, Social Worker or Professional Clinical Counselor is required. Licensure may be required in multiple states as applicable based on State requirement of the work assigned
• Case Management Certification is highly preferred
• Advanced degree associated with clinical licensure is preferred
• A minimum of three (3) years of experience in nursing or social work or counseling or health care profession (i.e. discharge planning, case management, care coordination, and/or home/community health management experience) is required
• Three (3) years Medicaid and/or Medicare managed care experience is preferred

Competencies, Knowledge and Skills:

• Strong understanding of Quality, HEDIS, disease management, supportive medication reconciliation and adherence    
• Intermediate proficiency level with Microsoft Office, including Outlook, Word and Excel  
• Ability to communicate effectively with a diverse group of individuals
• Ability to multi-task and work independently within a team environment
• Knowledge of local, state & federal healthcare laws and regulations & all company policies regarding case management practices
• Adhere to code of ethics that aligns with professional practice
• Knowledge of and adherence to Case Management Society of America (CMSA) standards for case management practice
• Strong advocate for members at all levels of care
• Strong understanding and sensitivity of all cultures and demographic diversity
• Ability to interpret and implement current research findings
• Awareness of community & state support resources
• Critical listening and thinking skills
• Decision making and problem-solving skills
• Strong organizational and time management skills

Working Conditions:

• Required to use general office equipment, such as a telephone, photocopier, fax machine, and personal computer
• Flexible hours, including possible evenings and/or weekends as needed to serve the needs of our members

Candidates will use their own equipment for assignments. Please verify the type of equipment they have.
Must have a M3 or higher for MAC
Must have an intel Core i3 or higher in other PC

Benefits for Community Based Care Manager:

• Immediate enrollment in Health Insurance
• Dental Insurance
• Life Insurance
• Employee Assistance Program (EAP)
• Access to Investment Accounts
• Career and educational tools within our Ingenovis ACT (Advocacy) Program

Pay Details: $40.00 per hour – $47.00 per hour

Interested in being considered?
If you are interested in applying to this position, please click Apply Now for immediate consideration.

For additional consideration, please email a copy of your resume to patrick.jamito@healthcaresupport.com with your phone number, the job title and location, and our recruiters will reach out.
Healthcare Support Staffing, LLC is an equal employment opportunity employer and will consider all qualified applicants without regard to race, color, religion, disability, sex, sexual orientation, gender identity, national origin, protected veteran status, or any other characteristic protected by applicable local, state, or federal law.

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