What are the responsibilities and job description for the Case Manager/Health Coordinator, IHMS - QUEST position at Hawaii Medical Service Association?
Employment Type
Exempt or Non-Exempt
Job Summary
**Hybrid Work Environment - Must reside on Oahu **
Pay Range: $68,000 - $133,000
Note: Individuals typically begin between the minimum to middle of the pay range
The Case Manager/Health Coordinator (CM/HC) will provide coordination of services for HMSA's QUEST members.
A CM/HC is an individual who is part of a multi-disciplinary team who coordinates, monitors, and ensures that appropriate and timely care is provided to the member. The CM/HC is responsible for assessing member needs, developing a person-centered care plan, and facilitating the delivery of appropriate physical and behavioral health services across the continuum of care.
Minimum Qualifications
- Must meet all State certification and licensure requirements for a social worker, mental health counselor, licensed nurse, or other healthcare professional. (Health care professional is defined as a physician, podiatrist, optometrist, psychologist, dentist, physician assistant, physical or occupational therapist, speech-language pathologist, audiologist, registered nurse, license clinical social worker, nurse practitioner, or any other licensed or certified professional who meets the state requirements of a health care professional).
- One year of relevant healthcare experience.
- Knowledge of care information systems, managed care and health care benefits.
- Basic knowledge of Microsoft Office applications. Including but not limited to Word, Excel, and Outlook.
- Reliable transportation to perform in person (Face to Face) meetings with members in their home or in alternative settings.
Duties and Responsibilities
- Conduct timely face to face assessments and develop, document, and implement targeted health action plans/care plans based on the results of the assessment for members requiring assistance with care coordination.
- Coordinate a multi-disciplinary team to develop a person- centered care plan to include but not limited to member's PCP, other service providers as appropriate, the member, and others determined by the member including family members, caregivers, and significant others in order to ensure timely access to appropriate medical care, behavioral health care, and services.
- Document and resolve issues for eligible HMSA members and providers on appropriate electronic systems.
- Provide continuity of care when members are discharged from a hospital to avoid re-admissions
- Coordinate and monitor activities among internal departments, external community agencies including DHS, Medicare, and the DOH programs, as well as HMSA partners/vendors.
- Utilize compiled data received from member encounters to assure the services provided meet the member's needs.
- Assist manager in updating or establishing new policies and procedures as needed or identified.
- Provide assistance in resolving any concerns about service delivery or providers.
- Performs all other miscellaneous responsibilities and duties as assigned or directed.
Salary : $68,000 - $133,000
