CM Care Coordinator

JOB DESCRIPTION

JOB TITLE: Case Management Coordinator FLSA STATUS: Non-Exempt

DEPARTMENT: Population Health

REPORTS TO: Supervisor, Case Management

JOB SUMMARY: Responsible for assisting the Nurse Case Managers to help members with chronic illnesses, mental health issues or life- altering conditions in accordance with the standards and requirements established by the Centers for Medicare and Medicaid.

ESSENTIAL JOB FUNCTIONS:

1. Work collaboratively with the clinical team to engage, educate, communicate, and coordinate care with clients, their family, behavioral health, medical and dental providers, community resources and others in ensuring that all services prescribed in the individualized service plan are implemented.

2. Assist in all case management functions associated with the case manager’s caseload including outreach and follow-up, staffing, client transportation, completing assessments and service planning processes and identifying the need for further or specialty evaluations.

3. Maintain the member’s comprehensive clinical record, including clinical documentation (assessments, provision of services, coordination of care, discharge planning, etc).

4. Provide continuous evaluation of the effectiveness of treatment through the ongoing assessment of the client and input from the client and relevant others resulting in modification to the service plan as necessary.

5. Adheres to payroll policies and properly uses timekeeping system with minimal manual changes.

6. Maintains regular and consistent attendance.

7. Adheres to Compliance Plan and HIPAA regulations.

MARGINAL JOB FUNCTIONS:

1. Takes on special projects as needed.

2. Performs other duties as assigned.

BEHAVIORAL EXPECTATIONS:

1. Continuous Learning:

a. Attends staff meetings as required.

b. Attends appropriate training, seminars and workshops as required

2. Customer Focus:

a. Maintains client/customer confidentiality and privacy in accordance with HIPPA regulations

and IMAS’s Standards of Conduct.

b. Fosters appropriate communication and relations with Supervisor, co-workers and other staff.

3. Quality/Process Improvement/Safety

a. Reports issues of security, health and/or safety to appropriate supervisor as soon as practicable.

b. Supports and demonstrates safety throughout all duties performed.

c. Follows established policies and procedures and understands and complies with all regulators

standards set forth by governing entities.

POSITION REQUIREMENTS:

EDUCATION/EXPERIENCE:

· High school graduate or equivalent.

· Min. 1 year managed care or case management experience

SKILLS/KNOWLEDGE/ABILITY:

· Familiarity with Medi-Cal and Medicare

· Spanish speaking or other second language a plus

· Willingness and ability to read, write, speak, understand English and have the communications skills necessary to provide accurate information to members and staff.

· Willingness and ability to follow written and verbal direction in English.

· Willingness and ability to maintain appropriate level of confidentiality and privacy.

· Willingness and ability to interact professionally with all customers, members, and co-workers, individually and as part of a team.

· Willingness and ability to effectively handle multiple items/tasks as required and adapt favorably to changing priorities.

· Willingness and ability to make appropriate judgments, decisions and problem solving in a timely manner and within the context of the situation at hand.

· Ability to effectively prioritize items/tasks as required.

· Willingness and ability to take initiative and be a self-starter.

· Willingness and ability to understand and comply with Federal, State, and local regulations.

LICENSURE/CERTIFICATE/TRAINING:

· n/a