Description
In this role, you will manage a caseload in collaboration with Care Management Leadership, ensuring personalized support for each enrollee. You will regularly contact enrollees based on their needs, conduct face-to-face visits, and assess their situations to identify barriers and facilitate improved care. Your focus will be on quality care coordination and management activities, adhering to organizational policies and national standards.
Responsibilities
- Manage a caseload in collaboration with Care Management Leadership.
- Conduct regular contact with enrollees and their caregivers.
- Perform face-to-face visits as needed in various locations.
- Assess enrollees upon enrollment and at intervals based on their needs.
- Carry out care coordination and management activities.
- Collaborate with the Senior Care Manager to prioritize cases and set objectives.
- Document enrollee interactions and findings accurately.
- Participate in discharge planning activities.
- Communicate effectively with enrollees and caregivers.
- Assist enrollees in understanding preventive services.
- Review reports from vendors and coordinate follow-up care.
- Refer enrollees to appropriate vendors for assistive technologies.
- Support enrollees during transitions in care.
- Process authorizations for services requiring approval.
- Maintain professionalism and a customer-focused demeanor.
Qualifications
- 3 to 5 years of relevant experience in managed care or care management.
- 3 to 5 years of experience in clinical or community resource settings.
- Strong verbal and written communication skills; bilingual (Spanish) preferred.
- Familiarity with medical terminology and healthcare systems.
- Proficiency in computer systems, especially Microsoft Office Suite.
- Excellent organizational skills and decision-making abilities.
- Ability to thrive under pressure while providing exceptional customer service.
- Willingness to participate in professional meetings.
License/Certifications
- Licensed in DC as a Social Worker (LICSW) or Registered Nurse (RN).
- Certification as a Case Manager is preferred.
Education
- Associate's degree required; Bachelor's degree preferred.
Work Environment
This role may involve moderate mental/visual stress, with periods of concentrated work using a PC keyboard and monitor. Some weekends, evenings, or early hours may be required to accommodate enrollee needs.
Equal Opportunity Employer
We are committed to creating an inclusive environment and are proud to be an equal opportunity employer. We do not discriminate on the basis of race, creed, color, religion, gender, sexual orientation, gender identity, national origin, age, disability, marital status, veteran status, or any other characteristic protected by law.
Employment Type: Full-Time