CareSource
Healthcare
CommunityBasedCareManager
“Community Based Care Manager at CareSource. Skills: Care management, Member engagement, Care plan development. Collaborate with inter-disciplinary care team. Improve quality and meet member needs”
What You'll Achieve.
Improve quality; Meet member needs; Improve health disparities; Improve access to frameworks; Achieve goals; Maximize positive member outcomes; Make timely decisions; Make informed decisions; Improve health; Improve wellness; Improve safety; Improve adaptation; Improve self-care; Ensure coordination; Avoid duplication of services; Ensure effective administration; Make member experience easier
Industry & Context.
Identify and manage barriers; Identify and implement interventions; Identify gaps in care; Identify gaps in access
Regular travel, May travel greater than 50%, Requires driver's license, Influenza vaccination required, Reside in assigned territory
What They're Looking For.
Must Have
Nursing degree or Bachelor's degree, Registered Nurse, Professional Clinical Counselor or Social Worker licensure, Minimum three years of experience in nursing, social work, counseling, or health care profession, Three years Medicaid and/or Medicare managed care experience
Nice to Have
Advanced degree associated with clinical licensure, Three years Medicaid and/or Medicare managed care experience
What You'll Do.
Collaborate with inter-disciplinary care team
Improve quality and meet member needs
Deliver culturally competent care
Coordinate services and supports
Facilitate communication
Coordinate care and service
Complete health and psychosocial assessments
Identify and plan needs
Assist member in creation of care plans
Evaluate person-centered care plans
Prioritize and address needs
Engage member and natural support system
Complete health and psychosocial assessments
Use motivational interviewing
environmental factors
Improve health disparities
Improve access to frameworks
Facilitate inter-disciplinary care team meetings
Engage member in various settings
Establish professional relationships
Develop and update person-centered care plans
Identify and manage barriers
Implement effective interventions
Empower member to manage health
Educate member about treatment options
Educate member about community resources
Educate member about insurance benefits
Employ ongoing assessment
Document member response
Evaluate member satisfaction
Monitor concerns or issues
Promote effective utilization of healthcare resources
Verify member eligibility
Verify enrollment history
Verify current health status
Complete psychosocial assessments
Gather information from stakeholders
Oversee psychosocial assessments
Oversee care planning
Oversee execution of member needs
Participate in meetings with providers
Inform providers of Care Management services
Assist with ICDS model of care orientation
Assist with training of providers
Identify gaps in care
Identify gaps in access
Collaborate with facility-based professionals
Plan for post-discharge care needs
Facilitate transition to appropriate care level
Coordinate with community-based organizations
Coordinate with state agencies
Coordinate with other service providers
Avoid duplication of services
Adjust intensity of programmatic interventions
Terminate care coordination services
Provide clinical oversight to unlicensed team members
Document care coordination activities
Document member response
Assess for process improvements
Share improvements with leadership
Travel to conduct member visits
Travel to conduct provider visits
Travel to conduct community-based visits
Adhere to NCQA standards
Adhere to CMSA standards
Perform other job duties as requested
How You'll Work.
Team & Collaboration
Inter-disciplinary care team; Facility-based healthcare professionals; Community-based organizations; State agencies
Communication Scope
Effective communication
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