- Coordinates care that is safe, timely, effective, efficient, equitable, and client/member centered.
- Handles case assignments, drafts community-based carepath plans (including both informal and paid care) and reviews member progress toward carepath goals.
- Advocates for informed decisions by members regarding their status and treatment.
- Develop effective working relationships and cooperates with multiple teams throughout the case management process; may include primary care providers, managed care plans, home and community-based service providers (HCBS), informal caregivers etc.
- Communicates effectively with all members of the team, including formal and informal caregivers.
- Records and documents case information completely and accurately in accordance with Care Management Services guidelines.
- Collaborate with internal team members, including Program Support Specialists for Care Management Services, to ensure communication for continuity of care for cases assigned.
- Identifies and resolves carepath variances as they occur; consults with internal and external teams as indicated to ensure effectiveness of community carepath.
- Refers members to a wide variety of community resources as indicated, for formal and informal assistance.
- Works to preserve the essential role of family and informal caregivers in assisting members in meeting carepath goals and addressing social risks.
- Promotes quality and cost-effective interventions and outcomes.
- Assesses and addresses member motivational and behavioral barriers to optimal health and function.
- Assists in removing barriers to primary and specialized medical care, to support optimal health and functional status.
- Meets all mandated reporting requirements.
- Takes call on a rotating basis as assigned.
- Maintains and monitors quality through effective collaboration with Quality Assurance and Education Coordinator for Care Management Services and Administrator for Care Management Services.
- Ensures effective implementation of Quality Assurance and Education plans, initiatives and processes.
- Maintains prompt, accurate and secure documentation as it relates to member needs, contacts and plans.
- Ensures appropriate documentation is filed promptly in members' chart as outlined in operational Care Management Services Guidelines.
- Ensures member information is secure when removed from the assigned location.
- Accurately reports work time and business expenses in accordance with organizational guidelines.
- Provides on-site assistance for all state surveys, unless previously excused by Administrator for Care Management Services.
- Reports corporate compliance concerns appropriately.
- Participates in weekly multidisciplinary team meetings prepared to discuss assigned members and to present new members.
- Participates in weekly staff meetings.
- Participates in all meetings and in-services as required.
- If a Licensed Practical Nurse or Registered Nurse, may be required to perform Assessment Nurse LPN duties as needed.
- Assists with Case Manager duties for other locations as needed.
- Promotes the image and reputation of the System by exhibiting servant leadership and providing direct and open lines of communication.
- Contributes to the work of committees, workgroups, project management, and other collaborative efforts of the System.
- Performs other duties as necessary to ensure the success of the System.
- Thorough knowledge of, adheres to current regulations, Personnel and Operational Guidelines and best practices related to the operations of the Elderly and Disabled Waiver Program and the organization.
- Performs all duties of the Case Manager as outlined in state and program regulations, as well as operational guidelines.
- Demonstrated listening skills, to understand what client's has needs and develop a plan that will address the needs.
- Compassion, especially dealing with difficult family or complex social issues.
- Completes work in a timely, accurate, and efficient manner.
- Exceptional organization and planning skills as well as the ability prioritize assignments/responsibilities.
- Cultural awareness and competence, to understand and value client's unique perspectives.
- Maintains constructive working relationships with all member of the interdisciplinary team by communicating and interacting effectively with supervisors, organizational leadership, peers and individuals inside and outside the System, in a positive, professional and respectful manner.
- Portrays a positive image of the organization and communicates guiding principles, mission, vision and values.
- Excellent knowledge of case management principles.
- Consistently reports to work on time prepared to perform duties of the position.
- Ability to work a demanding, primarily self-directed work schedule.
- Demonstrates good judgment and decision-making.
- Ability to deliver excellent customer service, externally and internally as well as maintain customer confidentiality.
- Ability to react effectively and calmly in emergency situations.
- Bachelor's degree in Social Work or related human services field is required with 3 years of experience
- Or Valid Georgia LPN license with 3 years of experience
- Experience in social work, home and community based services, healthcare or geriatrics preferred.
- Valid Driver's License.
- Reliable Transportation.
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Case Manager for Care Management Services - Macon, United States - CHSGa
Description
Join us at
NextStep Care
- a place where you'll be valued, recognized and rewarded for the vital work you do each day. We'll surround you with a strong team and leadership that supports every aspect of your life - both inside and outside of our centers. And you'll get to practice your passion in a non-profit, mission-driven organization that's known for the highest level of care in our communities
SUMMARY
Responsible for serving as the member's liaison and advocate assisting members and their informal caregivers in accessing services and by coordinating care among multiple providers to ensure needs are met for duration of their length of stay. The role will provide ongoing follow up to determine if both formal and informal care meet the goals of the member's carepath and maintain optimal health status and community residence.
ESSENTIAL DUTIES AND RESPONSIBILITIES
LANGUAGE SKILLS
Ability to read and interpret documents such as safety rules, operating and maintenance instructions and procedure manuals. Ability to write routine reports and correspondence. Ability to speak effectively before groups of customers or associates of the organization.
MATHEMATICAL SKILLS
Ability to add, subtract, multiply and divide in all units of measure, using whole numbers, common fractions, and decimals.
REASONING ABILITY
Ability to apply common sense understanding to carry out instructions furnished in written, oral or diagram format. The ability to deal with problems involving several concrete variables in standardized situations.
COMPUTER APPLICATION SKILLS
This job requires proficiency with the following computer applications:
Microsoft Outlook Microsoft Excel Microsoft Word
CERTIFICATES, LICENSES, REGISTRATIONS
Please see minimum qualifications
PHYSICAL DEMANDS
The physical demands described here are representative of those that must be met by an associate to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
While performing the duties of this job, the associate is regularly required to sit, talk or hear. The associate frequently is required to walk. Use hands to finger, handle or feel and reach with hands and arms. The associate is occasionally required to stand. Specific vision abilities required by this job include close vision, distance vision and the ability to adjust focus.
EEO / M / F / D / V / Drug Free Workplace
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