Job Description
Position Overview:We are seeking a compassionate and detail-oriented Care Manager to join our team. In this role, you will provide care coordination and management services to support individuals in navigating their healthcare needs. You will work closely with enrollees, caregivers, and healthcare providers to ensure seamless care transitions, improve health outcomes, and close gaps in care.
Key Responsibilities:
Manage a caseload as assigned by Care Management Leadership.
Engage with enrollees at scheduled intervals based on their needs, providing additional support as necessary.
Conduct face-to-face visits in various settings, including enrollees' homes, physician offices, and other agreed-upon locations.
Assess enrollees upon enrollment and at regular intervals to identify needs, barriers, and opportunities for care improvement.
Coordinate care and case management activities with attention to quality, timeliness, and compliance with industry standards.
Collaborate with Senior Care Managers to prioritize cases, set objectives, and address potential risks or utilization concerns.
Seek guidance from senior team members for specialized care needs.
Maintain accurate and timely documentation of enrollee interactions and assessments in accordance with organizational policies.
Uphold confidentiality policies related to enrollee information.
Participate in discharge planning, ensuring enrollees and their families are connected to appropriate healthcare resources.
Educate enrollees and caregivers on preventive health services, emphasizing the importance of compliance with recommended care.
Apply advanced knowledge of target population conditions and standard care management approaches.
Review provider reports and facilitate coordination of follow-up care as needed.
Guide enrollees in utilizing assistive technology, understanding medication administration, and self-management techniques within scope of practice.
Assist enrollees in navigating care transitions, including changes in healthcare providers, aging out of programs, or transitioning between care settings.
Process authorizations for services requiring approval by Care Management staff.
Communicate effectively with enrollees, families, and healthcare providers to promote understanding and collaboration.
Maintain professionalism and a customer-focused approach in all interactions.
Utilize strong time management and organizational skills to effectively balance workload.
Qualifications:
3-5 years of experience in managed care, care management, or community resource settings.
Strong verbal and written communication skills.
Bilingual (Spanish-speaking) preferred.
Familiarity with medical terminology and healthcare delivery systems.
Proficiency in Microsoft Office and other relevant computer applications.
Excellent organizational skills and ability to interpret and apply departmental requirements.
Sound decision-making and judgment skills.
Ability to work under pressure, meet deadlines, and provide outstanding customer service.
Experience participating in professional, multidisciplinary meetings with internal and external teams.
Licensure & Certifications:
Active licensure in Washington, D.C., as a Licensed Independent Clinical Social Worker (LICSW) or Registered Nurse (RN).
Certification as a Case Manager is preferred.
Education Requirements:
Associate's degree required; Bachelor's degree preferred.
Work Environment:
This role may involve extended periods of computer use and screen time.
Some evening, early morning, or weekend work may be required to accommodate enrollee needs.
If you are passionate about making a difference in people's lives and have the experience and skills needed for this role, we encourage you to apply!
Employment Type: Full-Time
Salary: $ 43.00 Per Hour
Job Tags
Hourly pay, Full time, Home office, Afternoon shift, Early shift,