Enhanced Care Case Manager

Enhanced Care Case Manager

La Brea - Los Angeles, CA 90016

Overview

Salary Range $25.00 - $29.00 Hourly

Description

Under the direct supervision of the RN Program Manager the Enhanced Care Case Manager is the Lead Care Manager (LCM) for the Enhanced Care Management Program and is responsible for coordinating and implementing organization-wide Enhanced Care Management. Utilizing strong organizational and communication skills, the LCM ensures the delivery of safe and efficient care, working cooperatively in an interdisciplinary team to provide support for members experiencing homelessness, serious mental illness/substance use disorder, and/or high medical needs. They oversee and implement provision of the ECM services; and identification and achievement of Care Plan goals and objectives with the member that meet their self-identified strengths and health care and psychosocial needs.

Essential Duties and Responsibilities:

• Engages eligible ECM members
• Offers services where the ECM member lives, seeks care, or finds most easily accessible and within health plan guidelines
• Oversee provision of ECM services and implementation of the Care Plan
• Connects with ECM member via phone or in-person to facilitate engagement, assessment, follow-up, and education/training visits to develop and address the Care Plan.
• Works in conjunction with ECM member to identify Care Plan goals and objectives.
• Connects ECM member to other Community Supports / social services and supports he/she may need.
• Accompanies ECM member to office visits, as needed and according to health plan guidelines.
• Arranges transportation.
• Responsible to convene care conference meetings.
• Coordinates with ECM resource partners to obtain data/information to ensure accurate Care Plan updates.
• Utilizes eCW and other electronic tracking systems to coordinate services and input data for reporting.
• Attends required ECM trainings.
• Facilitates internal ECM trainings/updates to T.H.E.'s clinical and administrative staff members.
• Collaborates with T.H.E.s IT department to ensure ECM templates are appropriate and effective at capturing needed data/information.
• Reviews existing T.H.E.s protocols and polices to match ECM requirements.
• Develops new ECM protocols, policies, and accompanying workflows.
• Assists the required ECM reports and other internal reports.
• Responsible for coordinating with those individuals and/or entities to ensure a seamless experience for the Member and non-duplication of services
• Advocate on behalf of Members with health care professionals
• Use motivational interviewing, trauma- informed care, and harm-reduction approaches
• Coordinate with hospital staff on discharge plan
• Accompany Member to office visits, as needed and according to T.H.E. and MCP guidelines
• Monitor treatment adherence (including medication) | May 2023 Provide health promotion and self- management training
• Other duties as assigned.

Education and Qualifications

• Bachelor's Degree in a healthcare, behavioral healthcare, social work, human services, or related field with one year of experience, preferably in working with patients in a clinic setting, providing home health care for patients, or social services case management services to low-income populations with one or more of the following: complex chronic conditions, high utilizer of emergency room and tertiary health care services, severe mental illness, and/or homelessness.
• Licensed Vocational Nurse (LVN), licensed behavioral health care professional, social worker, substance abuse counselor, health educator, or other similar paraprofessional preferred.
• MPH or related fields preferred
• Bilingual in English/Spanish (oral and written)

Knowledge. Skills and Abilities:

• Strong documentation skills.
• Ability to multi-task and prioritize when needed.
• Ability to independently seek out resources and work collaboratively.
• Ability to develop and maintain good working relationships with staff.
• Ability to use computer and learn new software programs.
• Excellent interpersonal skills reflecting clarity, diplomacy, and the ability to communicate accurately and effectively with all levels of staff and management.
• Demonstrates ability to work in a regulatory climate that includes oversight of state and federal entities, payer contracts etc.
• Possesses ability to communicate effectively, both verbally and in writing.
• Proficient knowledge of Microsoft Outlook, MS Word, and Excel.
• Able to travel and attend professional meetings, conferences, trainings, and clinic sites.
• Performs other related duties as assigned.