Lead Care Manager - Non-Clinical

FUNCTIONS & RESPONSIBILITIES

• Engage in patient interaction per eligibility requirements and standards as set by the program.
• Oversee provision of ECM services and implementation and evaluation of the Care Plan.
• Participates in the development of the clinical strategic and operational plans along with social worker, and medical providers and provides leadership needed to achieve medical goals.
• Maintains knowledge and adheres to all company policies and procedures and regulatory standards.
• Completes timely reports and coordinates with insurance companies for approval and authorization.
• Able to perform complete enrollment evaluations.
• Oversee Services and Health action plan implementation, monitor treatment adherence and help with medication management.
• Provides regular communication with the staff regarding pertinent organizational and patient issues.
• Communicates with all members of the multidisciplinary team to improve the quality of patient care. Participates in patient care conferences and makes regular entries in inpatient care logs.
• Educates patient on the proper use of the Emergency Room and provides information for alternatives. Coaches patients in effective management of their chronic health conditions, and self-care. Assists patient in understanding care plans and instructions. Motivates patients to be active and engaged participants in their health and overall wellbeing.
• Responsible for coordinating with those individuals and/or entities to ensure a seamless experience for the patient and non-duplication of services.
• Offer services where the patient lives, seeks care, or finds most easily accessible and within Managed Care plan guidelines.
• Connect patient to other social services and supports the patient may need, including transportation.
• Advocate on behalf of patients with health care professionals.
• Use motivational interviewing, trauma-informed care, and harm-reduction approaches.
• Career with hospital staff on discharge plans.
• Accompany patient to office visits, as needed and according to Managed Care plan guidelines.
• Provide health promotion and self- management training

QUALIFICATIONS

• Education: High School Diploma
• Experience: 1+ years of experience in Complex Care Management, hospice or home health setting is preferred.
• Core Competencies: Proficient in Microsoft Word, Excel, and Outlook. Excellent written, oral communication and presentation skills. Strong attention to detail. Solid organizational and analytical competencies that result in the ability to manage multiple tasks and follow instructions.
• Other: Valid Driver’s License and Auto Insurance