What are the responsibilities and job description for the Medical Case Manager position at Bad River Health & Wellness Center?
Job Summary: The Medical Case Manager provides comprehensive, culturally responsive care coordination and support services to members of the Bad River Band and surrounding community. This position focuses on improving health outcomes by addressing medical needs, behavioral health concerns, and social determinants of health through collaboration with tribal healthcare providers, community resources, and traditional healing supports. The Medical Case Manager promotes wellness, prevention, and self-management while honoring tribal values, traditions, and community strengths.
Essential Duties and Responsibilities include the following. Other duties may be assigned by the Program Manager or the supervisor.
- Conduct holistic assessments that include physical health, behavioral health, social, environmental, and cultural factors.
- Develop individualized care plans in partnership with patients, families, healthcare providers, and community support.
- Coordinate referrals to internal tribal programs (Public Health, Behavioral Health, Clinic, CHR Program, Social Services) and external healthcare providers.
- Monitor client progress and provide follow-up to ensure continuity of care and goal attainment.
- Assist with transitions of care following hospitalizations or specialty appointments.
- Conduct home visits and community outreach to engage individuals who may have barriers to accessing healthcare.
- Collaborate with Community Health Representatives (CHRs), elders, and community leaders to support client needs.
- Participate in community health events, wellness programs, and prevention initiatives.
- Support outreach to vulnerable populations, including elderly, families, and individuals with chronic illnesses.
- Assist clients with navigating healthcare systems, insurance, referrals, and transportation resources.
- Advocate culturally appropriate services and equitable access to care.
- Help clients access community resources related to housing, food security, financial assistance, and social services.
- Provide culturally relevant education on chronic disease management, preventive care, medications, nutrition, and wellness.
- Support health promotion initiatives addressing priority community health needs identified through community assessments.
- Encourage self-management skills and empowerment through motivational interviewing and coaching approaches.
- Work collaboratively with tribal clinic providers, nurses, behavioral health staff, CHRs, and public health programs.
- Participate in interdisciplinary case conferences and care team meetings.
- Coordinate services with external healthcare systems, hospitals, and specialty providers when needed.
- Maintain accurate documentation in electronic health records according to tribal, federal, and regulatory requirements.
- Participate in quality improvement activities and program evaluation efforts.
- Assist with data collection and reporting for grants, public health initiatives, and community health programs.
Required Education and/or Experience
- Associate or bachelor’s degree in nursing.
- Registered Nurse (RN)
- Demonstrated dependability, strong work ethic, and consistent punctuality.
- Ability to maintain confidentiality and communicate clearly with patients, staff, and providers.
Preferred Education and/or Experience
- Experience working in a Tribal health system, IHS clinic, or community/public health
· environments.
- Familiarity with electronic health records.
- Understanding of Tribal community values, traditions, and culturally responsive care
· practices
- Maintain Valid Driver’s License
Pay: From $35.00 per hour
Benefits:
- Dental insurance
- Employee assistance program
- Employee discount
- Health insurance
- Life insurance
- Paid time off
- Vision insurance
Work Location: In person
Salary : $35