Responsible for health care management and coordination of healthcare members
Works with members to create and implement an integrated collaborative plan of care.
Coordinates and monitors Healthcare member's progress and services
Provides case management services to members with chronic or complex conditions including proactively identifies members that may qualify for potential case management services.
Conducts assessment of member needs
Identifies, assesses and manages members per established criteria.
Develops and implements a case management plan in collaboration with the member, caregiver, physician and/or other appropriate healthcare professionals
Documents care plan progress in healthcare information system.
Evaluates effectiveness of the care plan and modifies as appropriate
Measures the effectiveness of interventions to determine case management outcomes.
Promotes integration of services for members including behavioral health and long-term care
Conducts face to face or home visits as required.
Bachelor's degree in Nursing or master's degree in Social Work, or Health Education (a combination of experience and education will be considered in lieu of degree
0-2 years of clinical experience with case management experience.
Active, unrestricted State Registered Nursing license or Licensed Clinical Social Worker LCSW or Advanced Practice Social Worker APSW in good standing. A combination of experience and education will be considered in lieu of LCSW or APSW.
Must have valid driver's license with good driving record and be able to drive locally.