Care Case Manager

Job Description

Essential Duties and Responsibilities:

● Engages eligible members

● Offers services where the member lives, seeks care, or finds most easily accessible and within health plan guidelines

● Oversee provision of services and implementation of the Care Plan

● Connects with member via phone or in-person to facilitate engagement, assessment, follow-up, and education/training visits to develop and address the Care Plan.

● Works in conjunction with member to identify Care Plan goals and objectives.

● Connects member to other Community Supports / social services and supports he/she may need.

● Accompanies member to office visits, as needed and according to health plan guidelines.

● Arranges transportation.

● Responsible to convene care conference meetings.

● Coordinates with ECM resource partners to obtain data/information to ensure accurate Care Plan updates.

● Utilizes eCW and other electronic tracking systems to coordinate services and input data for reporting.

● Attends required trainings.

● Facilitates internal trainings/updates to clinical and administrative staff members.

● Collaborates with IT department to ensure ECM templates are appropriate and effective at capturing needed data/information.

● Reviews existing T.H.E.s protocols and polices to match ECM requirements.

● Develops new ECM protocols, policies, and accompanying workflows.

● Assists the required ECM reports and other internal reports.

● Responsible for coordinating with those individuals and/or entities to ensure a seamless experience for the Member and non-duplication of services

● 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 plan

● Accompany Member to office visits, as needed and according to T.H.E. and MCP guidelines

● Monitor treatment adherence (including medication)

● Provide health promotion and self- management training

● Other duties as assigned.

Required Education and Qualifications:

● Bachelor’s Degree in a healthcare, behavioral healthcare, social work, human services, or related field with one year of experience, preferably in working with patients in a clinic setting, providing home health care for patients, or social services case management services to low-income populations with one or more of the following: complex chronic conditions, high utilizer of emergency room and tertiary health care services, severe mental illness, and/or homelessness.

● Licensed Vocational Nurse (LVN), licensed behavioral health care professional, social worker, substance abuse counselor, health educator, or other similar paraprofessional preferred.

● MPH or related fields preferred

● Bilingual in English/Spanish (oral and written)

Knowledge. Skills and Abilities:

● Strong documentation skills.

● Ability to multi-task and prioritize when needed.

● Ability to independently seek out resources and work collaboratively.

● Ability to develop and maintain good working relationships with staff.

● Ability to use computer and learn new software programs.

● Excellent interpersonal skills reflecting clarity, diplomacy, and the ability to communicate accurately and effectively with all levels of staff and management.

● Demonstrates ability to work in a regulatory climate that includes oversight of state and federal entities, payer contracts etc.

● Possesses ability to communicate effectively, both verbally and in writing.

● Proficient knowledge of Microsoft Outlook, MS Word, and Excel.

● Able to travel and attend professional meetings, conferences, trainings, and clinic sites.

● Performs other related duties as assigned.Company Description

T.H.E. Health and Wellness Centers is a nonprofit community clinic in South Los Angeles. For more than 50 years, we've provided high-quality, low cost healthcare and preventative education for all.

We are an Equal Opportunity Employer.