Care Manager

Job Summary

The Care Manager conducts comprehensive health risk assessments, develops individualized care plans, and coordinates services for members in managed care programs. This role focuses 85% on care management across hospitals, SNFs, LTACs, recuperative care, and member homes, ensuring holistic support for physical, functional, social, psychological, cultural, and linguistic needs.[ from prior]

Key Responsibilities

Care Management (85%)

• p]:pt-0 [&>p]:mb-2 [&>p]:my-0" style=""> Complete standardized health risk assessments and annual disease-specific clinical evaluations of members' physical, functional, social, psychological status, cultural/linguistic needs, caregiver resources, and benefits.
• p]:pt-0 [&>p]:mb-2 [&>p]:my-0" style=""> Perform post-discharge assessments post-hospital/ED, covering status updates, follow-up scheduling, DME/supplies, and community resources.
• p]:pt-0 [&>p]:mb-2 [&>p]:my-0" style=""> Develop member-specific care plans with prioritized SMART goals; review/update annually or upon condition changes.
• p]:pt-0 [&>p]:mb-2 [&>p]:my-0" style=""> Conduct regular outreach, face-to-face meetings (hospitals, SNFs, LTACs, member homes), and schedule follow-ups to track progress and barriers.
• p]:pt-0 [&>p]:mb-2 [&>p]:my-0" style=""> Coordinate with members, families, providers, Community Supports, LTSS, behavioral health/substance use services, physicians, specialists, agencies, and vendors.
• p]:pt-0 [&>p]:mb-2 [&>p]:my-0" style=""> Participate in Interdisciplinary Care Team meetings, route complex cases to leadership, and maintain detailed documentation.
• p]:pt-0 [&>p]:mb-2 [&>p]:my-0" style=""> Advocate for funding, treatment options, timelines, and progress evaluation.
  
  

Administrative Support (10%)

• p]:pt-0 [&>p]:mb-2 [&>p]:my-0" style=""> Support departmental goals with focus on customer service, dignity, and accountability.
• p]:pt-0 [&>p]:mb-2 [&>p]:my-0" style=""> Document interventions per protocol and report productivity metrics.
  
  

Other Duties (5%)

• p]:pt-0 [&>p]:mb-2 [&>p]:my-0" style=""> Handle additional projects as assigned.
  
  

Minimum Qualifications

• p]:pt-0 [&>p]:mb-2 [&>p]:my-0" style=""> Bachelor’s degree in social work, psychology, gerontology, public health, or social science.
• p]:pt-0 [&>p]:mb-2 [&>p]:my-0" style=""> 5 years clinical and/or managed care experience.
• p]:pt-0 [&>p]:mb-2 [&>p]:my-0" style=""> Valid driver’s license, reliable transportation, acceptable driving record, and current auto insurance (20% fieldwork).
  
  

Preferred Qualifications

• p]:pt-0 [&>p]:mb-2 [&>p]:my-0" style=""> LVN, LMFT, or Master’s in social work, gerontology, public health, or related field.
• p]:pt-0 [&>p]:mb-2 [&>p]:my-0" style=""> Behavioral health or substance use case management experience.
• p]:pt-0 [&>p]:mb-2 [&>p]:my-0" style=""> Certified Case Manager (CCM).
• p]:pt-0 [&>p]:mb-2 [&>p]:my-0" style=""> Bilingual (English Arabic, Farsi, Chinese, Korean, Russian, Spanish, or Vietnamese).
  
  

Knowledge & Abilities

• p]:pt-0 [&>p]:mb-2 [&>p]:my-0" style=""> Build rapport across levels; work independently with sound judgment.
• p]:pt-0 [&>p]:mb-2 [&>p]:my-0" style=""> Communicate clearly (verbal/written); manage flexible schedule (occasional evenings/weekends).
• p]:pt-0 [&>p]:mb-2 [&>p]:my-0" style=""> Organize, analyze, problem-solve; proficient in Microsoft Office and care platforms.
• p]:pt-0 [&>p]:mb-2 [&>p]:my-0" style=""> Thrive in fast-paced settings, managing multiple projects and teams.
  
  

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