Care Manager (Outagamie and Calumet) (Home-Based with Field Travel)

About the role

Join an interdisciplinary team (IDT) that serves frail elders, adults with physical disabilities, and adults with intellectual/developmental disabilities who are members of Lakeland Care (LCI). The team’s goal is to promote overall well-being through high-quality, person-centered, outcome-based care. Under the general direction of the Care Management Supervisor, this position provides care management and service coordination to LCI members.

As part of the IDT, the Care Manager arranges services and supports based on a comprehensive assessment of the member's identified outcomes and needs. The team monitors service provision according to the member-centered plan, LCI policy, and Department of Health Services (DHS) contract requirements.

Responsibilities

• Conduct comprehensive assessments of members' outcomes, needs, and risks as part of an interdisciplinary team (including an RN Care Manager, the member, and/or legal representative), and reassess as the member’s condition changes.
• Collaborate with the RN Care Manager to coordinate acute and primary care services, care transitions, and related follow-up care.
• Develop, coordinate, monitor, and evaluate outcome-based, member-centered plans, considering cost and effectiveness when authorizing services and selecting providers.
• Coordinate care and benefits to ensure a comprehensive support approach and ongoing access to federal and state programs.
• Implement risk mitigation strategies to promote members' health, safety, and independence while respecting their rights.
• Educate members about their rights to appeal and grieve decisions, and facilitate their participation in the appeal/grievance process.
• Participate in ongoing training to maintain compliance with federal and state regulations, LCI policies, and professional standards.
• Create and maintain member records as required by the Department of Health Services (DHS) contract and LCI policy.
• Coordinate and participate in home visits and care conferences with members, their supports, and providers to assess and reassess long-term care needs.
• Participate in the 24-hour on-call rotation as needed.
• Attend team meetings and internal workgroups as required or requested.
• Maintain confidentiality of member information and protected health information (PHI) in accordance with state, federal, and HIPAA regulations.

Requirements

• Certified Social Worker in the State of Wisconsin with a minimum of one (1) year of experience working with at least one of the Family Care target populations, or
• A four-year bachelor’s degree or more advanced degree in Human Services or a related field with one (1) year of experience working with at least one of the Family Care populations, or
• A four-year bachelor’s degree or more advanced degree in any other field with a minimum of three (3) years of experience working with at least one of the Family Care target populations.
• Working knowledge of computers, programs, typing, and data entry.
• Ability to access members’ homes, which may not comply with ADA regulations.
• Ability to multitask and work in a fast-paced environment.
• Ability to lift up to 25 lbs.
• Current driver’s license, acceptable driving record, and proof of adequate insurance.

About Lakeland Care

Lakeland Care is a Wisconsin-based nonprofit organization focused on creating a world we all want to live in. As a managed care organization (MCO), we provide long-term care services to eligible elders and individuals with physical, intellectual, or developmental disabilities. We serve members in 22 counties and operate 11 offices throughout the central to northeastern region of Wisconsin.

Mission: Empowering individuals. Strengthening communities. Inspiring futures.

Vision: To create a world we all want to live in.

Core Values: Kindness, Inclusion, and Trust.