Bilingual Outreach Lead Care Manager coordinating healthcare management services for various members in California. Overseeing outreach efforts and developing individualized care plans in a hybrid work environment.
Responsibilities
Care Coordination: Manage an assigned caseload of adult and pediatric members
Conduct comprehensive assessments to determine the physical, emotional, and social needs of members
Develop individualized care plans based on assessment findings, considering medical history, preferences, and specific needs
Tailor care plans to individual needs and goals
Coordinate and facilitate communication between healthcare providers, social workers, therapists, and other members of the care team to ensure a comprehensive and integrated approach to care
Collaborate with Medical Doctors, Clinical Consultants, Housing Navigators and Leaders to make recommendations tailored to member needs
Continuously monitor the progress of members and update care plans as needed per policy and compliance requirements
Ensure prescribed treatments and interventions are being followed and communicate to PCP and specialty care providers any significant changes to member concerns along with any updates on member status
Provide positive client service experience through multiple support channels including telephonic and in-person; the Enhanced Care Management program is high touch and in-person centered
Maintain accurate and up-to-date records of assessments, care plans, and interactions with members
Ensure compliance with relevant regulations and standards
Complete all required documentation accurately in a timely manner and in accordance with company standards
Provide leaders with case progress periodically and on a required basis
Serve as an advocate for patients or clients, helping navigate the healthcare system, understand treatment options, and access the services required
Provide education to members and their families on health-related topics, treatment options, and self-care strategies
Identify and connect members with appropriate community resources, support services, and programs to address needs, such as housing assistance, financial aid, or counseling services
Help plan and coordinate the discharge process for members leaving hospitals or long-term care facilities, ensuring a smooth transition to home or another care setting
Opportunity to participate in training new employees
Outreach: Conduct telephonic or in-person outreach efforts to current or prospective members
Follow established policies to outreach, enroll, and exclude members
Verify enrollment eligibility for the Enhanced Care Management program
Complete referrals to the ECM program when necessary
Partner with healthcare professionals, community, social support services, and other healthcare entities to locate members
Answer inbound helpline and respond to member inquiries in a timely and professional manner
Continuously improve knowledge of Company products and services to better assist members
Utilize and review data sharing sites to collect and share patient health information and ER utilization with relevant care teams to initiate transition of care
Review and verify the accuracy of member information file to ensure data is up to date and there are no errors
Perform other duties as assigned or required per departmental policy
Requirements
Associate degree and minimum 2+ years of healthcare or care coordination experience
Current and valid Driver’s License
Proof of auto insurance
Current BLS certification from the American Heart Association upon start date
Distraction-free home workspace with a secure internet connection
Benefits
Make an impact: an organization who cares about its employees, communities, and the future of healthcare
Inclusivity: be a part of a workplace where you not only belong but also can be the best version of yourself
Growth: opportunities to develop and grow your career with us
Community: you are encouraged to have a voice, share your opinions, and have an individual impact on the business
Paid Time Off: 12 holidays and up to 15 days of accrued PTO to rest and recharge plus additional time for sick, jury duty, bereavement, reproductive loss, and therapy
Work Life Balance: enjoy flexibility to maximize your well-being and success with our hybrid work model
Medical, Dental, & Vision Benefits: we cover up to 100% of your premium and 50% of your dependents depending on the plan
Prioritize your mental health with unlimited therapy sessions funded 100% by Titanium Healthcare
Flexible Spending, Health Savings & Dependent Care Accounts
Life/AD&D insurance funded 100% by Titanium Healthcare
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