Care Manager - Home to Provider

divh2Job Title/h2pJob Information/ppDate Opened 05/03/2017/ppJob Type Full time/ppCity San Bernardino/ppState/Province California/ppCountry United States/ph3Job Description/h3pEnhance seniors ability to manage their health and live independently by conducting care management including assessments, planning and implementing interventions, and communicating actionable client data to health provider. Hours: Monday-Friday, 8am to 5pm. Extended work hours, as needed. Work is primarily in the field (based out of home office), must be willing to travel in assigned area. Bi-monthly office visits to Long Beach. Will be expected to spend at least one day per week in medical group office, location to be determined. Maintain valid drivers license, automobile insurance and reliable transportation./ppResponsibilities:/pulliDevelops individualized care plan utilizing evidence-based guidelines and clinical knowledge for client and provider by evaluating and conducting home visits, gathering assessment information, and identifying problems, goals and interventions./liliDelivers ongoing care coordination/care management by coaching, educating, navigating and referring to appropriate care and community based resources./liliAssists clients and caregivers in taking an active role in chronic disease management and health prevention, by coaching, using motivational interviewing and educating about self-management tools and strategies./liliDevelops cross-functional relationships with medical groups by attending appropriate meetings, working on-site, and structuring effective communication mechanisms./liliCoordinates with health care team to identify barriers to treatment plan by sharing home assessment information./liliAchieves best use of staff resources by supporting community health worker and dividing workload efficiently./liliCompletes timely and accurate documentation in multiple computer systems to record assessment and corresponding documentation, including care plans, and progress notes./liliExhibits strong interpersonal, critical thinking and analytical skills through positive communication with clients, caregivers, healthcare team and community agencies./liliDemonstrates excellent organizational, decision-making and multi-tasking skills as demonstrated by problem solving and successful outcomes./liliEnhances skills and knowledge by participating in team case conferences and training, per department guidelines./liliUtilizes department desktop procedures, workflows, job aids and training materials./liliIdentifies barriers to work processes and brings to the attention of the supervisor/manager./liliAdheres to all quality, compliance and regulatory standards./liliMaintains professional and technical knowledge by attending educational workshops; reviewing and contributing to professional publications; establishing personal networks; participating in professional societies./liliContributes to team effort by accomplishing related results as needed./li/ulpQualifications: Mandatory bilingual Spanish 8+ years in medical managed care field with a Bachelors Degree, OR 3+ years in medical managed care field with a Masters Degree in Social Work, Gerontology Demonstrated knowledge of assessment, health and functional problems of older adults Knowledge of community resources for seniors. Basic knowledge of related, CMS and DHCS regulations. Proficient in MS Office./ppCare Navigators On Demand is an Equal Opportunity Employer and does not discriminate on the basis of race or ethnicity, religion, sex, national origin, age, veteran disability or genetic information or any other reason prohibited by law in employment./p/div