Lead Care Manager responsible for case management of members in the Enhanced Care Management program, improving health and well-being through services and support.
Responsibilities
The LCM is responsible for 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
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 member client service experience through multiple support channels including telephone and in-person
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/required basis
Advocate for patients or clients, helping them navigate the healthcare system, understand their treatment options, and access the services they require
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 their needs, such as housing assistance, financial aid, or counseling services
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
Participate in training new employees
Perform other duties as assigned or required per departmental policy
Requirements
Associate degree and 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
Current TB test
Distraction-free home workspace with a secure internet connection
Fluent in English (written and verbal), Bilingual in Spanish
Competent with computers, email, virtual platforms, Excel and other Microsoft Office based programs
Prior use of Electronic Medical Records
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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