Population Health Care Manager I, MSW

Overview Provides comprehensive care management and transition of care services within a multidisciplinary team to improve quality, reduce cost, promote optimal patient health and well-being across the continuum of care, and promote patient and provider satisfaction. Utilizes data analytics, population health principles, and quality measures to facilitate delivery of high quality, cost effective, patient-centered, holistic care to optimize patients? health and health outcomes. Implements the case management process to assess, plan, implement, coordinate, monitor, and evaluate resources and services to promote optimal health and health outcomes of high risk, complex patients experiencing behavioral health and/or complex social determinant of health-related barriers or needs. Conducts psychosocial assessments and facilitates interventions to address identified need(s). Delegates care plan tasks to appropriate care team members. Collaborates with providers, practices, care team members, community agencies, and patient support networks. Promotes optimal health and self-management through advocacy, empowerment, multi-modal communication, education and coaching, behavioral health support, behavior change support, identification of and connection with resources, facilitation of efficient service delivery, and promotion of a positive patient-PCP relationship. Supports providers and practice?s ability to deliver quality care and care management services. May include home, community, inpatient, and/or ambulatory-based patient encounters. Accountable for consistently achieving quality metrics. Licensure Not Applicable Education Master's Degree Social Work Required Experience No Experience Required EEO EOE #J-18808-Ljbffr Case Management Society of America (CMSA) ®