Description

CLASSIFCATION SUMMARY:

Volunteers of America Southwest’s (VOASW) Enhanced Care Management (ECM) program provides a whole person approach to care for Medi-Cal beneficiaries. VOASW believes in individualizing services based on need and what works best for the member, thus through care management and care coordination we asses need and connect individuals to services and resources most appropriate for them. Through the delivery of these services we hope every member can improve their quality of life, establish a support system and develop healthy living choices. The Care Manager is the primary point of contact for Medi-Cal beneficiaries and directly provides care management and care coordination services. Care Managers are responsible for completing comprehensive assessments, establishing care plan, coordinating services and referrals and providing education and support to help members make healthy lifestyle choices. Care Managers facilitate conversations between interdisciplinary Care Teams (including Community Health Workers, Care Coordinators, Lead Care Managers, primary care physicians, and other providers delivering care to the member.) 

ESSENTIAL DUITES AND RESPONSIBILITES:

Client caseload management:

• Conduct assessments and reassessments, care planning, and care management

• Schedule in-person/home visits and electronic check-ins with members

• Maintain extensive knowledge of local community support services, inducing but not limited to health care, mental health care, housing, basic needs, etc.

• Coordinate care and services with external care providers including PCPs, Specialty Physicians, Nurses, Psychologists, Psychiatrists, ect.

• Document interactions with member including direct and indirect services

• Provide ongoing support and education to members regarding health lifestyle choices

• Regularly review and update care plan.

• Work with Medi-Cal and community providers to coordinate services for members

• Provide members with education and services to prevent ER visits, hospitalizations and readmissions.

Organizational and administrative duties:

• Participate in Care Team meetings and Care Conferences

• Document client services EHR. Track all services provided to member including direct and indirect services and time spent on each activity

• Establish and retain client referral systems from care coordination systems

• Complete reporting requirements according to organization standards

• Track client information, schedules, files, and forms in a confidential manner

• Maintain ongoing knowledge of program requirements, expectations and services

• Attend and represent the organization at professional conferences, in-service trainings, and meetings at the request of or with the approval of supervisor

• Participate quality assurance and monitoring activities for service delivery and documentation

STANDARDS OF EXCELLENCE:

• Processes requested or needed information on or before expected deadline. Information provided and received (operational and financial) is error-free and responsive to requests.

• Demonstrates and maintains competency in the specialty or discipline for which position is responsible.

• Demonstrates ethics, courtesy and respect, and creates an approachable environment.

• Identifies options and solutions to a problem when confronted with a challenge.

• Looks at rationale associated with each situation to determine and verify the logic and correctness based on historical or current data.

• Maintains confidentiality, uses good judgement and continually keeps Manager/Director updated on any unusual or emergency situations.

• Provides excellent customer services to internal and external customers

Qualifications

EDUCATION AND EXPERIENCE:

• BA, LMSW/LCSW/LMHC or RN/LPN degree

• 2 years minimum of case management experience

• Strong understanding of cultural competency with the target population

• Medi-Cal experience preferred

• Computer literacy necessary

Physical Requirements:

• Physical demands associated with office work

• Some travel required