Care Manager
Care Manager
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Salary Not Disclosed
1 Vacancy
Job Description
Qualifications for Care Manager
- Perform initial and annual home assessments for MediMedi members referred to Care Coordination determine eligibility for Long Term Services and Supports (LTSS).
- Assist Registered Nurse in determining Nursing Facility Level of Care assess for unmet home and community service needs as well as needs for complex case management referrals.
- Provide short term care coordination/case management which includes coaching education navigation and referrals to community based resources.
- Partner with team members to prepare Service Authorizations arrange coordinate and monitor service for members per department guidelines.
- Complete timely and accurate documentation in multiple computer systems to complete assessment and corresponding documentation: care plans service plans authorizations and progress notes as necessary.
- Follow SNP policy and procedures and ensures all appropriate assessments for this population are completed and acted upon within established timeframes.
- Maintain the members right to privacy and protects the operations by keeping information confidential.
- Adhere to all quality compliance and regulatory standards to achieve HCS and the outcomes.
Requirements for Care Manager
- Bachelors Degree in Social Work Nursing Gerontology or related field
- Must be bilingual English/Spanish
- Ability to actively service areas in and around Palm Springs Coachella and Hemet
- 3 years of experience in managed care or healthcare environment
- Demonstrated knowledge of assessment health and functional problems of older adults and managed care
- Basic knowledge of related NCQA standards CMS and DHS regulations
- Excellent organizational decisionmaking and multitasking skills
- Demonstrated customer focus; proactively finds ways to exceed customer needs
- Demonstrates keen attention to detail and produces high quality work products
- Ability to work well in a fastpaced and dynamic environment
- Proficient in MS Office
- Must maintain valid drivers license automobile insurance and have reliable transportation
- Masters Degree in Social Work (MSW) Preferred
- Medicare/Medicaid experience Preferred
Required Experience:
Manager
Employment Type
Full-Time
