Bachelor's degree - required 2 years experience - $41,567 per year
Master's degree - required 1 year experience- $47,818 per year
LMSW -required 1 year experience - $50,818 per year
JOB SUMMARY
Care Management is a service model whereby all of an individual’s caregivers communicate and interface so that the member’s needs are addressed in a comprehensive manner. This is done primarily through a “care manager” who oversees and provides access to all of the services an individual needs to assure that they receive everything necessary to prevent hospitalizations, stay healthy, and maintain stability.
The Care Manager is ultimately responsible for the overall provision and coordination of services to assigned caseload. The Care Manager guides program enrollees and their caretakers (legal guardians) through the health care system by assisting with access issues, developing relationships with service providers, and tracking interventions and outcomes.
GENERAL RESPONSIBILITIES
- Obtains required Care Management enrollment consents from the individual or legal guardian.
- Completes initial and ongoing needs assessments (Child and Adolescent Needs and Strengths; CANS) to determine the individual’s most appropriate level of care management.
- Responsible for the overall management of the patient’s Individualized Plan of Care. Through the creation of an Individual Plan of Care, the Care Manager is able to:
Coordinate the enrollee’s provision of services as per their acuity level.
- Support adherence to treatment recommendations.
- Monitor and evaluate a patient’s needs, including prevention, wellness, medical, mental health, care transitions, and social and community services where appropriate.
- Meets client contact requirements (keeping in mind that caseloads may be “blended”):
- Care Managers serving children will be required to have some face-to-face visits on a consistent schedule as per the mandates of their acuity level (high, medium, or low).
- Meets Care Management documentation requirements in a timely and accurate manner by effectively utilizing designated Care Management Portal (Medicaid Analytics Performance Portal; MAPP) and Electronic Health Records (EHRs) as needed.
- Functions as an advocate for clients within the agency and external service providers.
- Promotes wellness and prevention by linking enrollees with resources and services based on their individual needs and preferences.
- Educate the child/caregiver on care of chronic conditions, immunization, screening and other preventative interventions.
- Helps clients to obtain and maintain public benefits necessary to gain health care services, including Medicaid and cash assistance eligibility, Social Security, SNAP, housing, legal services, employment and training supports, and others.
- Effectively communicates and shares information with the individual and their families and other caregivers with appropriate consideration for language, literacy and cultural preferences.
- Conducts care planning meetings/conferences and serves as an interdisciplinary team member to effectively provide/coordinate comprehensive and holistic care.
- Identifies available community-based resources and actively manages appropriate referrals, access, engagement, follow-up and coordination of services.
- In the event of hospital admissions, actively engages in the discharge planning process ensuring that the patient has all recommended post discharge services in place prior to discharge.
- Attends and participates in ongoing staff development trainings to enhance skills needed to effectively meet the demands of the Care Manager position.
- Ensures that child has periodic evaluations and follow-up treatment for dental, vision and hearing care, following Medicaid EPSDT guidelines.
- All other duties, as needed, by Care Management Agency.
PHYSICAL REQUIREMENTS
- The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. An employee in this position is regularly required to stand; walk, use hands and fingers, handle, or feel objects; reach with hands and arms; talk and listen, and taste or smell. The employee frequently is required to walk. The employee is occasionally required to keep balance and stoop, kneel, crouch, or crawl.
- Computer – The Care Manager must be able to use a computer and able to learn software programs
- Office Equipment- The Care Manager is required to operate a fax, copier, scan, and other office equipment.
- Communication - The Care Manager needs to be able to speak, read and write fluently in the English language
- Writing - The Care Manager must be able to write in the English language using correct spelling, grammar, punctuation, etc.
- Driving - The Care Manager must have a valid Driver’s License and a clean driving record.
- Lifting - The Care Manager may frequently lift 0-25 lbs., occasionally lift 25-50 lbs., and rarely lift over 50 lbs.
- Push/Pull - The Care Manager may frequently push/pull 0-25 lbs. of force, occasionally push/pull 26-45 lbs. force, and rarely push/pull over 45 lbs.
- Sitting, Standing and Walking – The Care Manager will be required to sit, stand and walk throughout the work day.
- Stooping -The Care Manager may occasionally stoop. This is defined as bending body downward by bending spine at the waist.
- Kneeling -The Care Manager may occasionally kneel. This is defined as bending legs at knees to come to rest on knee(s).
- Crouching - The Care Manager may occasionally crouch. This is defined as bending body downward and forward by bending spine and legs.
- Work environment: The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. While performing the duties of this job, the employee frequently works in an office environment. The noise level in the work environment is usually moderate due to talk and movement of the program participants and other co- workers. The noise level can increase on occasion due to yelling or screaming by the participants of the programs.
Qualifications
QUALIFICATIONS
- Associate Degree with two years’ experience
- Bachelors of Arts or Science with two years’ experience
- Registered Nurse or Licensed Practical Nurse with two years’ experience
- A Master’s Degree in related field (Licensed preferred)
- Knowledge of best practice working with children and families in health, preventive and wellness care
- Bilingual a plus
Experience:
- Relevant expertise and experience in serving children and families in child welfare, developmental disabilities, mental health, healthcare and/or other systems as well as those receiving preventive services.
- Care Managers serving high acuity enrollees will be required to have demonstrated knowledge and understanding of the needs of such children and their families as evidenced by additional years of experience, education or training.
- Care Managers assigned to children who have medical fragility must have extensive experience in coordinating their care.
- Experience providing service coordination and information, linkages, and referrals for community-based services.
Additional Competencies:
- Excellent accountability, writing, communication, and organizational skills
- Compassion for servicing children and families with special needs
- Ability to travel to community-based agency offices, participant’s communities, and homes within assigned catchment area
- Ability to receive feedback to professionally grow and/or improve
- Proven decisiveness, motivational, and developmental skills; management abilities, including meeting deadlines, ensuring compliance with agency policies and procedures, and overseeing complete and timely maintenance of agency records, in accordance with contractual requirements
HOURS AND TIME OF WORK
Full-Time- 35 Hours per week
