Care Manager - Pediatrics

Job Summary

About the role

This role provides support for care management/care coordination activities and collaborates with a multidisciplinary team to coordinate the integrated delivery of member care across the continuum.

Responsibilities

• Completes assessments of members per regulated timelines and determines who may qualify for care coordination/care management based on triggers identified in assessments.
• Develops and implements care plan in collaboration with member, caregiver, physician and/or other appropriate health care professionals and member support network to address member needs and goals.
• Conducts telephonic, face-to-face or home visits as required.
• Performs ongoing monitoring of care plan to evaluate effectiveness, document interventions and goal achievement, and suggest changes accordingly.
• Maintains ongoing member caseload for regular outreach and management.
• Promotes integration of services for members including behavioral health, long-term services and supports (LTSS), and home and community resources to enhance continuity of care.
• Facilitates interdisciplinary care team (ICT) meetings and informal ICT collaboration.
• Uses motivational interviewing and Molina clinical guideposts to educate, support and motivate change during member contacts.
• Assesses for barriers to care, provides care coordination and assistance to member to address concerns.
• Collaborates with licensed care managers/leadership as needed or required.

Requirements

• At least 2 years experience in health care, preferably in care management, or experience in a medical and/or behavioral health setting, or equivalent combination of relevant education and experience.
• Demonstrated knowledge of community resources.
• Ability to operate proactively and demonstrate detail-oriented work.
• Ability to work within 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 self-motivation.
• Ability to demonstrate responsiveness in all forms of communication, and remain calm in high-pressure situations.
• Ability to develop and maintain professional relationships.
• 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.
• Microsoft Office suite/applicable software program(s) proficiency.

Qualifications

• In some states, a bachelor's degree in a health care related field may be required (dependent upon state/contractual requirements).

Skills

• Knowledge of community resources.
• Proactive and detail-oriented work.
• Ability to work within a variety of settings and adjust style as needed.
• Ability to work independently, with minimal supervision and self-motivation.
• Responsiveness in all forms of communication, and calmness in high-pressure situations.
• Professional relationships.
• Time-management and prioritization skills.
• Problem-solving and critical-thinking skills.
• Verbal and written communication skills.
• Microsoft Office suite/applicable software program(s) proficiency.

Benefits

Details about benefits will be provided upon hire.

Pay

Range: $27.61 - $53.83 / HOURLY

Schedule

Details about schedule will be provided upon hire.