Case Manager - Maysville, United States - PursueCare

Description

Job Description

Do you want to be part of the team removing barriers to addiction treatment? We are looking for tech-savvy problem-solvers to work as Case Managers, part of the front-line team connecting patients to services and guiding them through their treatment experience.

What You'll Do:

The Case Manager Level 3 performs all elements of targeted case management with our patients and supports other case managers in following PursueCare best practices for patient management.

• Encourage and intervene with the patient to keep them on track
• Use reporting & data to track patient success and identify deviations for treatment plans that require intervention
• Engage with patients in-person at partner locations
• Assist the patient in receiving ancillary services; setting up patients with primary care and social services as needed
• Support patients in using the app to receive services
• Support Case Managers Level 1 and Level 2 in their work with patients. This includes providing mentoring and training opportunities.
• May assume supervising position for team of case managers.
• Work directly with clinicians (addiction counselors, therapists, medication-assisted treatment physicians, and nurse practitioners) and PursueCare pharmacy staff to manage schedules and to coordinate care

Specific hands-on and mission-critical initiatives may include:

• Work with Patient Access Specialists to process new patient intakes.
  o Track and manage patient leads through the CRM
  o Intake patients in a timely, efficient, and customer-focused manner. The key drive is to get patients into the treatment services that they need within 24 hours of outreach to PursueCare
  o Assist patients in using PursueCareRx for all pharmacy needs
  o Confirm that all required authorizations and information are secured by Intake Specialists or by oneself
  o Assist patients in understanding their payment options
  o Assist patients in scheduling initial medical, therapy, and psych evaluations
• Perform all key case management functions, potentially from a clinic or office setting including:
  o Track and manage patient engagement through CRM and tracking tools
  o Perform targeted case management tasks as documented in the Care Coordinator manual and expectations documentation.
  o Ensure patients are receiving care in accordance with their treatment plan
  o Address patient and clinician concerns in a timely manner
  o Work with clinicians, partners, PursueCareRx, and outside agencies to coordinate care
  o Interact (typically via app chat) with every patient on your caseload 1x per week. Work with clients in person, via phone, live chat, email, and text environments
  o Work directly with patients to resolve payer questions and ensure they receive access to treatment options in a timely/immediate fashion
  o Document work with patient, clinicians, partners, and outside agencies in the EHR and other platforms as necessary
  o In addition to working with clients in a clinic setting, care may be coordinated around use of the telehealth platform.
• Train and mentor Case Manager Level 1 and Level 2 staff in their own case management duties. May assume supervising position for team of case managers.
• Travel to partner sites to assist patients and staff in-person with accessing treatment services.
  o Intake patients in accordance with PursueCare policies
  o Work directly with patients or partner staff to resolve payer questions and ensure patients receive access to treatment options in a timely/immediate fashion
  o Assist patients in accessing services both in person and via telehealth solutions in a clinic, partner location, and at home
• Work with clinicians to manage schedules in our clinic and telehealth platform
• Proactively address /escalate any reported concerns with all aspects of the PursueCare experience
• Perform other duties as directed by supervisor.

We're Looking For:

• Bachelor's or Master's degree in healthcare management, nursing, or other healthcare related field.
• Certification in case management required.
• Excellent computer skills and a demonstrated comfort with technology.
• Excellent and thoughtful verbal and written communication skills
• Excellent organizational skills
• Prior experience working remotely preferred.
• High volume inbound, outbound, and calling experience preferred
• Desire to learn and grow with our company - to put in the time, focus and effort necessary to advance to the next level of their career
• Work style, pace and drive to make things happen, with a bias for initiating and driving positive results
• Belief that healthcare reform begins with innovation aimed at making people's lives better

Physical Requirements/Work Environment:

• The physical demands described here are representative of those that must be met by an individual to successfully perform the essential duties of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential duties.
• Work is performed primarily in a traditional on-site clinical setting, pharmacy, or clinic, where the employee is regularly required to sit, stand, and demonstrate manual dexterity.

Where You'll Work:

PursueCare brings virtual evidence-based addiction treatment for opioids, alcohol, and other substance use disorders to patients through a smart phone application. PursueCare offers a low-barrier transitional digital addiction treatment program particularly beneficial for those experiencing significant barriers to in-person care. Through the app, patients can access doctors who prescribe Medically-Assisted Treatment ("MAT"), counselors and therapists, psychiatric care providers, at-home screening, supporting resources and a pharmacy that can ship medications directly to the patient. We partner with health systems, community health partners, employers, and health plans. Patients can also seek treatment without a referral. We are Joint Commission-accredited and maintain the highest standards for clinical excellence, while continually innovating how care is provided to vulnerable populations. For more information, visit

We offer qualifying employees flexible paid time off to allow our team members to properly recharge, competitive pay, bonus opportunities, comprehensive health benefits and a 401K with company contributions. PursueCare is headquartered in Middletown, CT with satellite locations in different regions. We offer work-from-home/remote opportunities for certain positions, based upon being able to meet the core competencies and requirements for the position from a home office. We pledge to be an Equal Opportunity Employer and pay living wages.

PursueCare is an equal opportunity employer and values diversity in our workforce. We encourage applications from all qualified individuals, including those with diverse backgrounds and those with disabilities.

PursueCare is not an emergency service. If this is an emergency seek care immediately by dialing
If you are experiencing distress or are at risk of suicide or harm confidential support is available to you by contacting the Suicide and Crisis Lifeline by dialing 9-8-8.