What are the responsibilities and job description for the Case Manager position at Group Health Cooperative of Eau Claire?
Position Purpose
With minimal supervision; plans, directs, and evaluates total managed care options for members and functions as part of an interdisciplinary team in accordance with established philosophy. The population of membership includes those with chronic medical conditions as well as mental health and AODA issues. Relates effectively with others for continuity of care; maintains satisfactory relations with others, maintains accurate and complete records, and upgrades policies, procedures, and skills of others within the department.
Essential Position Functions
With minimal supervision; plans, directs, and evaluates total managed care options for members and functions as part of an interdisciplinary team in accordance with established philosophy. The population of membership includes those with chronic medical conditions as well as mental health and AODA issues. Relates effectively with others for continuity of care; maintains satisfactory relations with others, maintains accurate and complete records, and upgrades policies, procedures, and skills of others within the department.
Essential Position Functions
- Initiate and implement a managed health care plan for health plan members. Work with members through difficult situations and provide support and tools to enable them to help themselves.
- Assess the social and emotional needs of members and work with them to develop strategies to foster their independence.
- Advocate on behalf of the member regarding accessibility of services; reduce resource consumption, and achieve positive member outcomes.
- Identify problems and provide the best possible solution.
- Accurately and promptly implement solutions that assist with member education and care management programs.Collaborate with co-workers and outside resources regarding continuity of care options.
- Participate in planning changes and improvements.
- Maintain a professional approach with the highest standard of confidentiality.
- Cooperate and maintain good rapport with staff, other departments, members, providers, and agencies involved in providing quality care to the member.
- Maintain the standards of accurate and complete documentation and reporting.
- Remain calm when accepting urgent requests or phone calls from others.
- Establish referral network/linkages with outside agencies for members.
- Attend professional workshops, seminars and in-service training.
- Maintain up to date knowledge of all changes in relevant discipline.
- Create a working climate that provides growth and job satisfaction to others within the department.
- Act as liaison between GHC and homeless assistance coalitions.
- The listing of essential and periodic functions is not to be considered an exhaustive list of all duties that may be performed.
Minimum Requirements of the Position
- A minimum of an associate’s degree in social work, human services or nursing.
- Active Wisconsin RN, LPN, or Social Work License required.
- D-SNP Case Managers will require active Wisconsin Registered Nursing license.
- Prefer candidates with work or volunteer experience in human services, patient care, or social work.
- Must demonstrate high degree of customer service skills, including excellent verbal and written communication skills.
- Must be able to work under pressure with strong attention to detail.
- Ability to learn and adapt in a changing environment.
- Ability to work with and influence a diverse population.
Group Health Cooperative of Eau Claire complies with applicable Federal civil rights laws and does not discriminate, exclude or treat candidates less favorably on the basis of race, color, national origin (including limited English proficiency and primary language), age, disability, or sex (including sex characteristics, including intersex traits; pregnancy or related conditions; sexual orientation; gender identity; and sex stereotypes).
The Cooperative is committed to fostering a caring and compassionate environment while ensuring that individual differences are valued. The Cooperative is a quality driven cooperative built on collaboration, community involvement, innovation, and belonging. It is essential that all employees and members feel secure and welcome, that the opinions and contributions of all individuals are respected and that all voices are heard.
This full time position offers an outstanding benefit package, including three weeks of vacation the first year, a generous retirement plan, health and dental insurance, a wellness program, and much more! If you are interested in working for an organization focused on a team atmosphere and is dedicated to providing exceptional service submit your resume today! Send resume to: resumes@group-health.com. Group Health Cooperative of Eau Claire is an affirmative action and equal opportunity employer.
The Cooperative is committed to fostering a caring and compassionate environment while ensuring that individual differences are valued. The Cooperative is a quality driven cooperative built on collaboration, community involvement, innovation, and belonging. It is essential that all employees and members feel secure and welcome, that the opinions and contributions of all individuals are respected and that all voices are heard.
This full time position offers an outstanding benefit package, including three weeks of vacation the first year, a generous retirement plan, health and dental insurance, a wellness program, and much more! If you are interested in working for an organization focused on a team atmosphere and is dedicated to providing exceptional service submit your resume today! Send resume to: resumes@group-health.com. Group Health Cooperative of Eau Claire is an affirmative action and equal opportunity employer.