Care Management Specialist II

Care Management Specialist II

The Care Management Specialist II coordinates with a multidisciplinary team care to provide person-centered interventions to health plan members, through effective partnerships with their caregivers/families, community resources, and their physician. He or she facilitates shared decision-making within and across settings to achieve coordinated high-quality care that is collaborative and timely.

Duties & Responsibilities

Essential Functions:

• Independently handle requests for care coordination, assessing the member's needs, and facilitating appropriate interventions and follow-ups.
• Administer Health Risk Assessment survey to members as needed.
• Prepare care plans for members for presentation at interdisciplinary team meetings.
• Assist members with appointments for specialists, educational classes, and transportation.
• Work with healthcare providers to coordinate and share plans of treatment.
• Perform data entry of medical information; maintain census tracking and reports.
• Assist Care Coordination Case Managers and staff to coordinate members' appointments, equipment, social services, and home health needs.
• Actively participate in team meetings.

Secondary Functions:

• Perform other duties as assigned.

Qualifications

The following represents the typical way to achieve the necessary skills, knowledge, and ability to qualify for this position:

Education and experience equivalent to:

• High school diploma or GED required.
• College level courses in health care, a plus.
• Three (3) years of managed care experience, preferably in Care Coordination.
• Experience working with the health needs of the population served.
• Experience as a Medical assistant or Licensed Vocational Nurse is a plus.
• At least one year of direct Care Coordination experience

Knowledge of:

• Personal computers and proficiency in Microsoft Office Suite applications, including Outlook, Word, Excel, Access, and PowerPoint.
• Care management, Medi-Cal, and Medicare benefits as well as the complexities of working with the elderly and disabled population.
• Community resources.

Abilities to:

• Work cooperatively with others.
• Work as part of a team and support team decisions.
• Communicate effectively, both verbally and in writing.
• Adapt to changes in requirements/priorities for daily and specialized tasks.

Other:

• Bilingual skills highly preferred, particularly Spanish, Tagalog, or Chinese.

Physical Requirements & Environmental Conditions of the Position

Activity/Physical Function - Not at all - 33% or less - 34% to 66% - More than 66%

Keyboarding/Repetitive Use of Hands - X

Standing - X

Walking - X

Sitting - X

Speaking - X

Hearing - X

Seeing - X

Lifting/carrying up to 20 lbs. - X

Lifting/carrying 21 to 50 lbs. - X

Lifting/carrying over 50 lbs. - X

Pushing or pulling - X

Overhead Reaching - X

Climbing/Kneeling/Crawling - X

Exposure to Environmental Conditions - Not at all - 33% or less - 34% to 66% - More than 66%

High Temperatures (over 85 degrees) - X

Low Temperatures (under 50 degrees) - X

Wet or High Humidity - X

Sudden Temperature Changes - X

Noise High Level - X

Noise - Vibrations - X

Hazards Mechanical & Electrical - X

Fumes/Odors/Smoke/Gas - X

The Health Plan of San Mateo (HPSM) is an equal opportunity employer and is committed to providing equal employment opportunities to all applicants and employees without regard to race, color, religion, creed, political affiliation, sex, gender, gender identity or expression, pregnancy, childbirth and related medical conditions, marital status, registered domestic partner status, sexual orientation, age, ancestry, national origin, citizenship status, veteran or military status, disability, medical condition, genetic information, or any other characteristic protected by applicable federal, state, or local law.

This policy applies to all aspects of employment, including recruitment, hiring, selection, placement, promotion, transfer, demotion, compensation, benefits, training, discipline, and termination.

HPSM is committed to providing reasonable accommodations to qualified individuals with disabilities and to applicants and employees with sincerely held religious beliefs or practices, in accordance with applicable law. If you require an accommodation during the application or interview process, or in order to perform the essential functions of a position, please contact the HPSM recruiter to request assistance.