Care Manager

Employee’s Name: Job Title: Care Manager

Supervisor: Director of Managed Care Start Date: November (Immediate Hire)

Department: Managed Care FLSA Status: Full-Time & Part-Time Non-Exempt

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GENERAL DESCRIPTION:

Care Management is a service model whereby all of a resident’s caregivers communicate and interface so that the resident'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 a resident 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.

MAJOR DUTIES AND RESPONSIBILITIES:

• Obtain required Care Management enrollment consents from the individual or legal guardian
• Complete initial and ongoing needs assessments (Child and Adolescent Needs and Strengths; CANS) to determine the individual’s most appropriate level of care management.
• Is responsible for the overall management of the patient’s Individualized Plan of Care. Through the creation of an Individual Plan of Carethe 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 resident’s needs, including prevention, wellness, medical, mental health, care transitions, and social and community services where appropriate.

• Meet client contact requirements (keeping in mind that caseloads may be “blended”):

• Care Managers serving children will be required to have some face-face visits on a consistent schedule as per the mandates of their acuity level (high, medium, or low).

• Meet 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
• Function as an advocate for clients within the agency and external service providers
• Promote 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 preventive interventions.
• Help 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 communicate and share information with the individual and their families and other caregivers with appropriate consideration for language, literacy and cultural preferences.
• Conduct care planning meetings/conferences and serves as an interdisciplinary team member to effectively provide/coordinate comprehensive and holistic care
• Identify available community-based resources and actively manages appropriate referrals, access, engagement, follow-up and coordination of services
• In the event of hospital admissions, actively engage in the discharge planning process ensuring that the patient has all recommended post discharge services in place prior to discharge
• Attend and participate in ongoing staff development trainings to enhance skills needed to effectively meet the demands of the Care Manager position
• Ensure 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
• Perform other duties as assigned

SKILLS and ABILITIES REQUIRED:

• Ability to communicate effectively with staff
• Excellent writing, communication, and organizational skills
• A passion for serving 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 self-management abilities, including meeting deadlines, ensuring compliance with agency policy and procedures, and overseeing complete and timely maintenance of agency records, in accordance with contractual requirements.

MINIMUM QUALIFICATIONS:

EDUCATIONAL:

• Associate Degree with two years’ experience
• Bachelor 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 (License preferred)

EXPERIENCE:

• Efficient knowledge of/ familiar with HRIS software

PREFERRED SKILLS:

• Bilingual is a plus
• Satisfactory computer software packages (MS Word, Excel, Outlook, etc.)
• Excellent oral and written communication skills
• Excellent problem –solving capability and capacity to meet multiple deadlines under pressure
• Highly organized and detail oriented
• 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.

BACKGROUND VERIFICATION and CLEARANCE:

• Credential Verification
• State Central Registry Clearance
• Justice Center clearance (SEL)
• Medical clearance, which includes TB screening.

LICENSE and ACTIVE CERTIFICATION:

• Must possess a valid driver’s license with a good driving record
• CPR/First Aid
• Safe Crisis Management (SCM)
• Mandated Reporter
• Trauma Informed Care
• Lasallian Culture of Care (LCC)

Martin De Porres Youth and Family Services is an Equal Opportunity Employer Committed to Diversity.'
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Work Location:

• One location

Work Remotely

• No

Job Types: Full-time, Part-time

Pay: $20.00 per hour

Schedule:

• 8 hour shift

Education:

• Associate (Preferred)

Work Location: On the road