Care Manager (Managed Care / Post Acute Care)

SUMMARY

The Care Manager for Belong Health’s Managed Care /Post-Acute Care program is responsible for applying care management principles when engaging members, beneficiaries and providers, to coordinate member/beneficiary care including developing and maintaining a collaborative relationship with provider practices, community-based resources, and the Belong Health team.  This is a customer facing remote position that involves a significant amount of interaction via phone with clients, members, beneficiaries, and patients. 

ESSENTIAL JOB DUTIES AND RESPONSIBILITIES

• Work directly with members and beneficiaries, their families and/or advocates, providers, and community service organizations on an ongoing basis to coordinate care that is safe, timely, effective, efficient, equitable, and reduces barriers to care. 
• Orient new members and beneficiaries to the Belong Health programs and educate the member/beneficiary and/or caregivers to care management services.  
• Advocate, empower, inform, and educate beneficiaries on self-management techniques.  
• Conduct assessments to identify barriers and opportunities for intervention. 
• Develop and implement individual care plans (ICP). 
• Lead interdisciplinary care team meetings. 
• Collaborate with providers, social workers, discharge planners, and community-based service providers to coordinate care and achieve care plan goals. 
• Document all care management activities in the appropriate system in accordance with internal and established documentation procedures.  
• Review electronic health records to gather information about beneficiary medical, behavioral health, and social conditions. 
• Promote a culture of accountability and performance to meet and exceed personal service vision goals and ensure timely and satisfactory resolution of highly complex, specialized, and non-routine customer issues. 

REQUIRED PROFESSIONAL EXPERIENCE AND QUALIFICATIONS

• Two or more years of experience in a health plan, health care organization (i.e. hospital or clinic), or Accountable Care Organization (ACO). 
• An active license as an Occupational Therapist (OT), Physical Therapist (PT) or Registered Nurse (RN).
• Proficient in navigating multiple systems; strong demonstrated PC skills using Microsoft applications. 
• Experience in participating in cross-departmental projects and policy and procedure changes, including coordination of activities and initiatives across departments. 
• Excellent customer service, trend identification, and analytical skills, with a demonstrated ability to solve problems effectively and efficiently; strong organizational and follow-through skills. 
• Commitment to high ethical standards in all work; protects the privacy of member and company data and exercises discretion in handling confidential member information. 
• Excellent oral and written communication skills, including presentation skills. 
• Strong active listening, issue assessment and problem-solving skills. 
• Self-directed and able to work autonomously and as part of a collaborative team.
• Comfortable in a fast-paced environment with multiple cases; able to organize and prioritize work.
• Excellent time management skills; organized and able to prioritize

 PREFERRED PROFESSIONAL EXPERIENCE AND QUALIFICATIONS

• Previous care management experience.
• Knowledge of community services and resources.
• Bi-lingual Spanish speaking.

 EDUCATION AND TRAINING

• A Bachelor of Science in Occupational Therapy, Physical Therapy or Nursing or equivalent is required.

 LICENSE AND CERTIFICATION

• Active, unrestricted Occupational Therapist (OT) license, (Physical Therapist (PT) license or a Registered Nursing (RN) is required. 
• Willingness to pursue additional state licensure, as needed, to meet business needs.

TRAVEL

This role may require some travel based on business needs, including but not limited to traveling to quarterly or semi-annual onsite meet ups.

SALARY RANGE

• $85,000-$100,000