Integrated Care Manager

The Integrated Care Manager (ICM) works collaboratively with the integrated care team to manage and coordinate care for a specific population of members whose needs represent high clinical and social risk in order to ensure quality and cost-effective member-centered care.Duties and ResponsibilitiesResponsibilities include, but are not limited to the following:Practice care management within the scope of licensure.Utilizes care management principles and sound clinical judgment in coordinating care for a specific member populationPerforms intensive care management functions for identified individuals in order to promote quality, cost-effective outcomes, including but not limited to:Performing a comprehensive assessment which includes care planning activities including the development of interventions, short and long-term goals in collaboration with member, family, PCP, behavioral health professionals and other involved health care professionals and community agencies, as appropriateCommunicate with providers to facilitate needed careImplements care plan, facilitates referrals, coordinates services, and resources and provides ongoing monitoring and re-evaluation of outcomesContinuous monitoring and evaluation of the care outcomes and identification of service gapsRegular review and revision of the plan of care in collaboration with the family and appropriate members of the health care team based on the outcomes and evaluative findingsOff-site visits (such as but not limited to home, hospital or community health centers or other community agencies) as necessary or requiredCompletes comprehensive documentation of all activities and contacts in Care Management software systemFacilitates referrals and coordinates needed servicesCollaborates with team as necessary in identifying needed services and supportsCommunicates with ancillary departments, such as Provider Relations and Member Services, as necessary to meet individual needs of members and providersMeets department and regulatory standards for accuracy, proficiency, and documentation in order to communicate decisions and plan of care in an appropriate and timely mannerProvides clinical oversight to community outreach and other team members, providing direct supervision of community outreach staff as appropriate regarding individual care statusServes as a clinical resource to respond to questions from various departmentsProvides cross-coverage as assignedParticipates in outreach/marketing activities as needed and as appropriateOther duties as assignedQualificationsRequired:Active, current, unrestricted RN, LMHC, LCDP, LCSW or LICSW license in RI in good standing (Consideration will be given to individuals without current RI license. Must provide documentation confirming application within 24 hours of offer)Minimum of two (2) years care management, behavioral health, or community health experiencePC based software programs – intermediate level of proficiencyStrong organizational and interpersonal skillsCustomer service orientationAbility to work independently and prioritize activitiesMust have access to reliable transportation. If using personal vehicle, must have active driver’s license and auto insurancePreferred:Managed Care experienceCertified Care ManagerDemonstrated experience working with Medicare, Medicaid, and commercial productsBachelors degreeMasters degreeBilingualBehavioral Health and/or Substance use expertiseNeighborhood Health Plan of Rhode Island is an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or veteran status. #J-18808-Ljbffr Neighborhood Health Plan of Rhode Island