ECM Case Manager

POSITION SUMMARY:

• The ECM case manager is a whole person, interdisciplinary approach to care that addresses the clinical and non-clinical needs of high cost and/or high-need members through systematic coordination of service and comprehensive care management that is community-based, interdisciplinary, high-touch, and person-centered. The case managers work, primarily through in-person, with members that have chronic health conditions, homeless or at-risk, high hospital admissions, substance abuse, behavioral needs, and/or transitioning from incarceration. Using excellent communication skills, case managers will provide services and coordination to members to ensure continuity of care across health and social service programs and community based and long term-support service programs. This position requires strong interpersonal and organizational skills in order to build rapport with members and to coordinate referrals and care amongst various healthcare providers and community services. The case manager also works with the member’s inter-disciplinary team (ICT) supporting the member. The case manager engages member and member support systems to define priorities that are central to the member’s desired needs and goals.

ESSENTIAL FUNCTIONS:

• Teach and assist members to better manage their chronic diseases using realistic and SMART (specific, measurable, attainable, realistic and timely) goals.
• Provide as-needed teaching to members during medical appointments in order to assist in the understanding of disease knowledge, medication compliance, specialty services recommended by primary care provider and/or any other medical needs the members may require assistance in understanding.
• Assist members and their families in problem solving potential issues related to the health care system, financial or social barriers (e.g., request interpreters as appropriate, transportation services or prescription assistance).
• Assist members with budgeting and money management as it relates to their medical needs.
• Use a step-by-step process when teaching skills.
• Use positive reinforcement and encouragement.
• Use a flexible approach with a diverse population.
• Attend both mandatory in-service trainings and related conferences to support a fundamental and expanded knowledge of Enhanced Care Management services and strategies to meet quality outcomes for ECM goals.
• Advocate on behalf of the members as needed, with the medical, behavioral, substance abuse, and treatment teams.
• May assume advocate role on the member’s behalf to ensure approval of the necessary supplies/services for the patient in a timely fashion.
• Manage own caseload while providing monthly care to all members as needed and reducing barriers to care.
• Provided community-based resources to members.
• Enroll and dis-enroll members into and out of ECM program.
• Completing Comprehensive Health Assessment Plan (HAP)
• Promoting health and working with member regarding provider’s health plan.
• Take lead with inter-disciplinary team (ICT) to complete needed program requirements.
• Complete documentation of encounters-notes for all care coordination services on member’s EHR.
• Utilizes computer for detailed data entry in multiple applications including Microsoft Office.
• Follow-up with member’s missed appointments and referrals.
• Follow-up with hospital/Urgent care discharges.
• Using motivational interviewing skills to engage and help members and their support system.
• Scheduling, appointment reminders, and coordination of transportation
• Complete required interagency and other necessary paperwork.
• Maintain confidentiality in accordance with clinic policies and HIPPA regulations.
• Follow required office procedures in a cooperative manner.
• Treat members with respect.
• Work in cooperation with co-workers and supervisory staff.
• Provide staff coverage as needed.

EDUCATION AND EXPERIENCE REQUIREMENTS:

• Education: Bachelor's degree in social work, sociology, psychology, AA in related field with 5 years of experience, OR Certified Nursing Assistant or bachelor's degree in related field (recreational therapy, human development, etc.).
• Experience: Two years in clinic service delivery or managed care environment in the capacity of care coordination role.
• Other Requirements: Possession of valid driver’s license and proof of State required auto liability insurance

Job Type: Full-time

Pay: From $22.00 per hour

Benefits:

• 401(k)
• Dental insurance
• Health insurance
• Life insurance
• Paid time off
• Vision insurance

Schedule:

• 8 hour shift

People with a criminal record are encouraged to apply

Experience:

• Case management: 1 year (Preferred)

Work Location: In person

Salary : $22