LEAD CARE MANAGER (King County Area) at BLEHEALTH
Date: 37 minutes ago
City: Hanford, CA
Salary:
$21
-
$23
per hour
Contract type: Full time
The Lead Care Manager (LCM) works in collaboration and continuous partnership with chronically ill or “high-risk” members and their family/caregiver(s), clinic, hospital and/or specialty providers and staff, and community resources in a team approach to:
- Coordinate with those individuals and/or entities to ensure a seamless experience for the member and non-duplication of services
- Engage eligible members
- Oversee provision of ECM services and implementation of the care plan
- Offer services where the member lives, seeks care, or finds most easily accessible and within the Plan guidelines
- Connect member to other social services and supports the member may need, including transportation
- Advocate on behalf of members with health care professionals
- Use motivational interviewing, trauma-informed care, and harm-reduction approaches
- Coordinate with hospital staff on discharge plans
- Accompany member to office visits, as needed and according to the Plan guidelines
- Monitor treatment adherence (including medication)
- Provide health promotion and self-management training
- Promote timely access to appropriate care
- Increase utilization of preventative care
- Reduce emergency room utilization and hospital readmissions
- Increase comprehension through culturally and linguistically appropriate education
- Create and promote adherence to a care plan, developed in coordination with the member, primary care provider, and family/caregiver(s)
- Increase continuity of care by managing relationships with tertiary care providers, transitions-in-care, and referrals
- Increase members’ ability for self-management and shared decision-making
- Connecting members to relevant community resources to enhance member health and well-being, increase member satisfaction, and reduce health care costs
- Connect and follow up with members, family/caregiver(s), providers, and community resources via face-to-face, secure email, phone calls, text messages, and other communications
- Serve as the contact point, advocate, and informational resource for members, care team, family/caregiver(s), payers, and community resources
- Work with members to plan and monitor care
- Assess member’s unmet health and social needs
- Develop a care plan with the member, family/caregiver(s), and providers (emergency plan, health management plan, medical summary, and ongoing action plan, as appropriate)
- Monitor adherence to care plans, evaluate effectiveness, monitor member progress on time, and facilitate changes as needed
- Create ongoing processes for members and family/caregiver(s) to determine and request the level of care coordination support they desire at any given time
- Facilitate member access to appropriate medical and specialty providers
- Educate members and family/caregiver(s) about relevant community resources
- Facilitate and attend meetings between members, family/caregiver(s), care team, payers, and community resources, as needed
- Cultivate and support primary care and specialty provider co-management with timely communication, inquiry, follow-up, and integration of information into the care plan regarding transitions-in-care and referrals
- Assist with the identification of “high-risk” members (the chronically ill and those with special health care needs), and add these to the member registry (or flag in EHR)
- Attend all Lead Care Manager training courses/webinars and meetings
- Provide feedback for the improvement of the ECM Program
- Offer services where the Member lives, seeks care, or finds most easily accessible and within Medi-Cal Managed Care health plans (MCP) guidelines
- Engage eligible Members
- Arrange transportation
- Call Member to facilitate Member visit with the ECM Lead Care Manager
- To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements below represent the required knowledge, skill, and/or ability. Reasonable accommodations may enable individuals with disabilities to perform essential functions
- This role will be hybrid, as there will be times when you will be required to report to our satellite office (or a specified, remote location) to work, to attend meetings, or other training
- Required to own and maintain a reliable automobile for this role - no exceptions
- You will receive a monthly mileage reimbursement per applicable state/federal laws, and a small, fixed monthly amount for basic Internet service reimbursement (TBD)
- You must have a valid driver’s license, proof of insurance, and a good driving record
- You will visit hospitals and visit patients at their homes, as needed
- Must present proof of Negative TB Test & CPR Certification before hire date
- Must complete a Live Scan Fingerprint/Background check (if applicable)
- An associate’s degree, or bachelor's degree in health science, or any related health care degree is preferred
- 1-2 years’ experience in case management preferred
- Bi-lingual (Spanish) a PLUS!
- Excellent analytical, problem-solving, and prioritization skills
- Excellent verbal and written communication skills
- High-level of interpersonal skills. Able to work collaboratively and tactfully with multi- disciplinary and diverse teams that may include employees, customers, and physicians
- Effective computer skills, particularly Microsoft Office, Excel, PowerPoint and Word
- Work independently to complete assigned tasks
- Team Building / Project Management-Execution / Change Management
- Quality and Process improvement tools
- MUST consistently achieve a minimum daily expectation of 25 schedules/day in-office, or 30 schedules/day working from home (Remote)
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