Case Manager - Pittsburgh - Murtech

    Murtech
    Murtech Pittsburgh

    3 days ago

    Default job background
    Full time Healthcare
    Description

    Job Description

    Job Title: Case Manager – USC Only
    Location: Remote - must be located in PA; prefer local to Pittsburgh, but can be located anywhere in the state
    Job Responsibilities:
    • Function as a primary clinician for members with complex health needs with the depth of engagement ranging from basic coaching to intensive case management. The goal is always to help develop and support the member's ability to self-manage and navigate the healthcare system.
    • Conduct telephonic clinical assessments that address the health and wellness needs of the Organization's members using a broad set of clinical and motivational interviewing skills.
    • Develop case or condition-specific plans of care using the clinical information system to establish short and long-term goals.
    • Establish a plan for regular telephonic contact with each member to review progress and assess potential additional needs.
    • Communicate with the member's treating provider or providers in more complex clinical situations requiring case management intervention.
    • Identify online, telephonic, and community-based resources that can assist the member in achieving and maintaining their personal health goals.
    • Proactively incorporate lifestyle improvement and prevention opportunities into member interactions and coaching.
    • Ensure all activities are documented and conducted in compliance with applicable business process requirements, regulatory requirements, and accreditation standards.
    Must have:
    • 5+ years of relevant experience.
    • Current licensure as a RN in the state of PA or Licensed Social Worker in PA.
    • Disease Management knowledge or experience.
    • Prior experience working in case management and managed care.
    • Experience with immunization.
    • Pediatric experience.
    • Experience working with those under the age of 21, including Early and Periodic Screening, Diagnostic and Treatment (EPSDT) experience and knowledge.
    • Experience with/familiarity with CPS (Child Protective Services).
    • Experience with/familiarity with well visits.
    • Certified Case Manager preferred.
    • Knowledge of assessments and care plans.
    • Experience with community resources.
    • Some knowledge of preventive health services.
    • 1-800-line experience preferred.
    • Experience working with the Medicaid population.
    • Great work ethic.
    • Able to work independently.
    • Telephonic outreach to members.
    • Excellent verbal and written communication skills.

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