Telephonic Case Manager

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 individual's and family's 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 client's health and psychosocial needs, including health literacy status and deficits, and develops a case management plan collaboratively with the client and family or caregiver. 

• Establishes an advocacy environment by providing emotional, psychological, and compassionate support to clients, friends, and families. 

• Plans with the client, family, or caregiver, the primary care physician/provider, other health care providers, the payer, and the community, to maximize health care responses, quality, and cost­ effective outcomes.

• Promotes client's independence by establishing clear goals; educating the client, the family or caregiver, and members of the health care delivery team about treatment options, community resources, payer benefits, psychosocial concerns, case management, etc., so that timely and informed 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 discipline's 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; reviewing professional 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 maintain confidentiality 

• 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 

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