Telephonic Case Manager
Telephonic Case Manager
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Salary Not Disclosed
1 Vacancy
Job Description
Job Purpose:
Promotes and restores individuals health and wellbeing by completing a collaborative process of assessment planning facilitation care coordination evaluation and advocacy for options and services to meet an individuals and familys comprehensive health needs through communication and available resources to promote quality cost effective outcomes. CMSA Standards of Practice
Duties:
Identifies care needs by establishing personal rapport with clients and other persons in a position to understand care requirements.
Conducts a comprehensive assessment of the clients health and psychosocial needs including health literacy status and deficits and develops a case management plan collaboratively with the client andfamily or caregiver.
Establishes an advocacy environment by providing emotional psychological and compassionatesupport to clients friends and families.
Plans with the client family or caregiver the primary care physician/provider other health careproviders the payer and the community to maximize health care responses quality and cost effective outcomes.
Promotes clients independence by establishing clear goals; educating the client the family orcaregiver and members of the health care delivery team about treatment options communityresources payer benefits psychosocial concerns case management etc. so that timely andinformed decisions can be made.
Assures quality of care by adhering to best practice standards; measuring health outcomes against client care goals and standards; making or recommending necessary adjustments; following case management and health or human service disciplines philosophies and standards of care set by state board of nursing applicable practice act and other governing agency regulations.
Facilitates communication and coordination between members of the health care team involving the client in the decision -making process in order to minimize fragmentation in the services encourage the appropriate use of health care services and maintain cost effectiveness.
Resolves client problems and needs by utilizing multidisciplinary team strategies empowering the client to problem solve by exploring options of care and alternative plans to achieve desired outcomes.
Strives to promote client self-advocacy and self-determination
Assists the client in the safe transitioning of care to the next most appropriate level
Advocates for both the client and the payer to facilitate positive outcomes for the client the health care team and the payer. However if a conflict arises the needs of the client must be the priority.
Documents case management services in client records .
Maintains client confidence and ethical and HIPAA standards by keeping information confidential.
Maintains professional and industry knowledge by attending educational workshops; reviewingprofessional publications; establishing personal networks; participating in professional societies.
Maintains a cooperative relationship among health care teams by communicating information; responding to requests; building rapport; participating in team problem-solving methods.
Contributes to Ascential Care Partners team effort by reflecting company philosophy and demonstrating ardent customer service-related results.
Other duties as assigned from time to time .
Skills/Qualifications
Current active and unrestricted Registered Nurse licensure with a degree from an institution that is fully accredited by a nationally recognized educational accreditation organization
A minimum of two years full-time work providing direct clinical care
Excellent interpersonal skills phone courtesy and organizational skills
Proficient in Microsoft Office products
Ability to maintain accurate records prepare reports correct English usage and maintainconfidentiality
Home office provision with access to high-speed internet and reliable cell phone network coverage
Preferred Qualifications
Bi-lingual (English and Spanish)
Five years experience in case management; preferably in workers compensation
Certification in the case management field or agreement to obtain certification within four (4) years. Recognized certifications include A-CCC CCM CDMS CMAC CMC CRC CRRN and COHN
Workspace and Physical Demands:
This position is 100% remote with hardware and software required for the job duties provided by Ascential Care Partners. The candidate must have a dedicated working space that supports adherence to privacy and confidentiality standards. Duties may involve moving materials weighing up to 10 pounds on a regular basis such as files books office equipment etc. and may infrequently require moving materials weighing up to 30 pounds. Manual dexterity and coordination are required while operating equipment such as computer keyboards cell phone calculator and standard office equipment.
Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
References:
CMSA Standards of Practice
URAC
Acrisure is committed to employing a diverse workforce. All applicants will be considered foremploymentwithout attention to race color religion age sex sexual orientation gender identity national origin veteran or disability status. California residents can learn more about our privacy practices for applicants by visiting the Acrisure California Applicant Privacy Policy available at Executive Search Firms & Staffing Agencies: Acrisure does not accept unsolicited resumes from any agencies that have not signed a mutual service agreement. All unsolicited resumes will be considered Acrisures property and Acrisure will not be obligated to pay a referral fee. This includes resumes submitted directly to Hiring Managers without contacting Acrisures Human Resources Talent Department.
Required Experience:
Manager
Employment Type
Full-Time
