Case Manager

divh2Case Manager/h2pIntegrated Resources Inc./ppTitle: Case Manager/ppPeriod: 3+Months/ppLocation: Cincinnati OH 45246/ppDescription: Temp with possibility to go permanent./ppShift is M-F hours during training 8 am to 5 pm, after training hours can be anywhere from 7 am to 6 pm, no OT./ppDuties: case plan development, setting up charts, arranging for in home services and transportation, and overseeing patients daily lives (medication and physician visits)./ppSkills:/pulliOrganization/liliKnowledge of medical equipment/liliStrong computer skills/li/ulpRequired License:/pulliActive, unrestricted State Registered Nursing license or Licensed Clinical Social Worker LCSW/liliActive, unrestricted State Registered Nursing license or Licensed Clinical Social Worker LCSW or Advanced Practice Social Worker APSW in good standing./liliMust have valid drivers license with good driving record and be able to drive locally./li/ulpRequired Experience:/pulli2-4 years of clinical experience with at least 1 year of case management experience./li/ulpWaiver positions:/pulliState requires 1 year of experience with waiver, home care, home and community based services or Home care experience/lili1-2 years of clinical experience with case management experience/liliHome and community based waiver experience is preferred./li/ulpRequired Education:/pulliBachelors degree in Nursing or Masters degree in Social Work, or Health Education (a combination of experience and education will be considered in lieu of degree)./li/ulpSummary: Responsible for health care management and coordination of members in order to achieve optimal clinical, financial and quality of life outcomes. Works with members to create and implement an integrated collaborative plan of care. Coordinates and monitors progress and services to ensure consistent cost effective care that complies with policy and all state and federal regulations and guidelines./ppEssential Functions:/pulliProvides case management services to members with chronic or complex conditions including: Proactively identifies members that may qualify for potential case management services./liliConducts assessment of member needs by collecting in-depth information from information system, the member, members family/caregiver, hospital staff, physicians and other providers./liliIdentifies, assesses and manages members per established criteria./liliDevelops and implements a case management plan in collaboration with the member, caregiver, physician and/or other appropriate healthcare professionals to address the member needs./liliPerforms ongoing monitoring of the plan of care to evaluate effectiveness./liliDocuments care plan progress in information system./liliEvaluates effectiveness of the care plan and modifies as appropriate to reach optimal outcomes./liliMeasures the effectiveness of interventions to determine case management outcomes./liliPromotes integration of services for members including behavioral health and long term care to enhance the continuity of care./liliConducts face to face or home visits as required./liliMaintains department productivity and quality measures./liliManages and completes assigned work plan objectives and projects in a timely manner./liliDemonstrates dependability and reliability./liliMaintains effective team member relations./liliAdheres to all documentation guidelines./liliAttends regular staff meetings./liliParticipates in Interdisciplinary Care Team (ICT) meetings./liliAssists orientation and mentoring of new team members as appropriate./liliMaintains professional relationships with provider community and internal and external customers./liliConducts self in a professional manner at all times./liliMaintains cooperative and effective workplace relationships and adheres to company Code of Conduct./liliParticipates in appropriate case management conferences to continue to enhance skills/abilities and promote professional growth./liliComplies with required workplace safety standards./liliKnowledge/Skills/Abilities:/liulliDemonstrated ability to communicate, problem solve, and work effectively with people./liliExcellent organizational skill with the ability to manage multiple priorities./liliWork independently and handle multiple projects simultaneously./liliStrong analytical skills./liliKnowledge of applicable state, and federal regulations./liliKnowledge of ICD-9, CPT coding and HCPC./liliSSI, Coordination of benefits, and Third Party Liability programs and integration./liliFamiliarity with NCQA standards, state/federal regulations and measurement techniques./liliIn depth knowledge of CCA and/or other Case Management tools./liliAbility to take initiative and see tasks to completion./liliComputer skills and experience with Microsoft Office Products./liliExcellent verbal and written communication skills./liliAbility to abide by policies./liliAble to maintain regular attendance based upon agreed schedule./liliMaintain confidentiality and comply with Health Insurance Portability and Accountability Act (HIPAA)./liliSkilled at establishing and maintaining positive and effective work relationships with coworkers, clients, members, providers and customers./li/ulh2Qualifications/h2pRequired License:/pulliActive, unrestricted State Registered Nursing license or Licensed Clinical Social Worker LCSW/liliActive, unrestricted State Registered Nursing license or Licensed Clinical Social Worker LCSW or Advanced Practice Social Worker APSW in good standing./liliMust have valid drivers license with good driving record and be able to drive locally./li/ulpRequired Experience:/pulli2-4 years of clinical experience with at least 1 year of case management experience./li/ulpWaiver positions:/pulliState requires 1 year of experience with waiver, home care, home and community based services or Home care experience/lili1-2 years of clinical experience with case management experience/liliHome and community based waiver experience is preferred./li/ulpRequired Education:/pulliBachelors degree in Nursing or Masters degree in Social Work, or Health Education (a combination of experience and education will be considered in lieu of degree)./li/ulh2Additional Information/h2pAll your information will be kept confidential according to EEO guidelines./p/ul/div

Careers Integrated Resources Inc