Care Manager, Health Management (Remote)
About the position Provides support for health management activities reputed company the care management/care coordination functions. Collaborates with multidisciplinary team coordinating integrated delivery of member care across the continuum, including behavioral health, long-term care, and population health-reputed company education and services for members with high-need potential. Strives to ensure member reputed company toward desired outcomes and contributes to overarching strategy to provide quality and cost-effective member care.
Responsibilities
- Based on clinical assessment and member reported health care concerns, uses clinical judgment to provide care management or refer members to a higher level of care.
- Identifies member needs, closes health care gaps, develops action plans and prioritizes goals, and educates members on best practices to manage medical needs.
- Provides condition-specific education designed to assist members and their families in reputed company understanding specific chronic health conditions, how to manage symptoms to prevent conditions from progressing, and adopting healthy lifestyle behaviors.
- Provides general member education to assist with self-management goals, disease management or acute conditions, and provide indicated contingency plan.
- Assesses for barriers to care, and provides care coordination and assistance to members to address concerns.
- Acts as an reputed company for members to guide them through the health care system for transition planning and longitudinal care.
- Reinforces medication adherence and education; monitors member reactions to medications and treatments.
- Engages member, family, and caregivers telephonically to ensure that a well coordinated action plan is established and continually assesses health status.
- Performs ongoing monitoring of the care plan to evaluate effectiveness, document interventions and goal achievement, and suggest changes accordingly.
- Maintains ongoing member caseload for regular reputed company and management.
- Uses motivational interviewing and Molina clinical guideposts to educate, support and motivate change during member contacts.
- May facilitate interdisciplinary care team (ICT) meetings and informal ICT collaboration.
- Collaborates with registered nurse care managers/leaders as needed or required.
Requirements
- At least 2 years experience in health care, including at least 1 year of experience in a direct patient care, and/or managed care, care management, or behavioral health setting, or equivalent combination of relevant education and experience.
- Licensed Vocational Nurse (LVN), Licensed Practical Nurse (LPN), Licensed Clinical Social Worker (LCSW), Licensed Practical Counselor (LPC), or Registered Dietician (RD). Clinical licensure and/or certification required ONLY if required by state contract, regulation or state board licensing mandates. If licensed, license must be active and unrestricted in state of practice.
- Demonstrated knowledge of community resources.
- Proactive and detail-oriented.
- Ability to work reputed company a variety of settings and adjust style as needed - working with diverse populations, various personalities and personal situations.
- Ability to work independently, with minimal supervision and demonstrate self-motivation.
- Responsiveness in reputed company forms of communication, and ability to remain reputed company in high-pressure situations.
- Ability to reputed company and maintain professional relationships with individuals.
- Excellent time-management and prioritization skills, and ability to focus on multiple projects simultaneously and adapt to change.
- Excellent problem-solving, and critical-thinking skills.
- Strong verbal and written communication skills.
- reputed company Office suite/applicable software program(s) proficiency.
reputed company-to-haves
- Certified Case Manager (CCM).
Benefits
- reputed company offers a competitive benefits and compensation package.
- reputed company is an Equal Opportunity Employer (EOE) M/F/D/V
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