Posted: Jan 11, 2018
Intensive Case Management—Case Manager (LCSW)
About the Job
Facilitates a team approach, including the Intensive Case Management (ICM) team, to ensure appropriate interventions, cost effective delivery of quality care and services across the continuum. Collaborates with the interdisciplinary care team which may include member, caregivers, member’s legal representative, physician, care providers, and ancillary support services to address care issues, specific member needs and disease processes whether, medical, behavioral, social, community based or long term care services. Coordinates care of individual clients with application to identified populations using assessment, care planning, implementations, coordination, monitoring and evaluation for cost effective and quality outcomes.
Facilitates a team approach, including the Intensive Case Management (ICM) team, to ensure appropriate interventions and community resources, cost effective delivery of quality care and services across the continuum. Collaborates with the Interdisciplinary Care Team which may include member, caregivers, member’s legal representative, physician, care providers, and ancillary support services to address care issues, specific member needs and disease processes whether, medical, behavioral, social, community based or long term care services.
Conducts in depth assessments and/or comprehensive needs assessment which include, but not limited to psycho-social, physical, medical, behavioral, environmental, and financial parameters.
Provides care coordination to members with chronic or complex conditions which require intensive interventions and oversight including multiple, clinical, social and community resources. Implements, coordinates, and monitors strategies for members and families to improve health and quality of life outcomes. Develops, documents and implements a plan which provides appropriate resources to address social, physical, mental, emotional, spiritual and supportive needs. Acts as an advocate for member’s care needs by identifying and addressing gaps in care. Performs ongoing monitoring of the plan of care to evaluate effectiveness. Measures the effectiveness of interventions as identified in the member’s care plan.
Develops and communicates plan for authorization of services, and serves as point of contact to ensure services are rendered appropriately, (i.e. during transition to home care, back up plans, community based services).
Conducts face to face home visits, as required,
Assesses and reviews plan of care regularly to identify gaps in care, trends to improve health and quality of life outcomes; works with members and the interdisciplinary care plan team to adjust plan of care, when necessary.
Promotes the appropriate use of clinical and financial resources in order to improve the quality of care and member satisfaction. Generates reports in accordance with care coordination goals.
Educates providers, support staff, members and families regarding care coordination role and health strategies with a focus on member-focused approach to care. Facilitates a team approach to the coordination and cost effective delivery to quality care and services.
Provides assistance to members with questions and concerns regarding care, providers or delivery system.
Maintains professional relationship with external stakeholders, such as inpatient, outpatient and community resources.
Complies with Case Management Society of America Standards for Case Management Practice and with CCMC code of Professional Conduct for Case Managers.
Participates in Interdisciplinary Care Team (ICPT) meetings.
May assist with orientation and continued mentoring of team members as appropriate.
Performs other functions as required.
Direct supervision is received weekly.
QUALIFICATIONS, EDUCATION AND EXPERIENCE
Education: Bachelors or higher
Bachelor’s Degree, Master’s preferred
Bachelor’s in applicable field of study, LCSW preferred
Certified Case Manager Preferred
Certification or Conditions of Employment:
Pre-employment background check
Competencies, Skills, and Attributes:
• Critical thinking and attention to detail
• Effective communication
• ICD 10 familiarity
• Microsoft Office
• Demonstration of high degree of independent problem solving and critical thinking skills.
• Ability to deal with all levels of staff and management within the organization, board members, as well as the public, under highly stressful conditions.
• Demonstrated ability to communicate effectively in person and via telephone with members, employer groups, brokers, physicians, and physician office staff using strong dialogue and customer service competencies.
• Written communication