Healthcare - Case Manager II

Job Description: EHR TEAM Emerging High Risk

****Below are the adjusted needs for each department. I apologize in advance for any back and forth moving forward as I suspect things will be happening real fast given the impending timeline of the contract ending June 30th. Fingers crossed we are able to extend it..***

EHR-5 openings (Central, Tidewater, South West, NOVA)

For this position we are seeking a Case Manager who lives in VIRGINIA.
Case Manager will work in remote and field setting supporting our EHR (Emerging High Risk), Medicaid Population. Case Manager will be required to physically go to member’s homes to complete Face to Face assessment. You will participate in interdisciplinary care team meetings for our members and ensure they have care plans based on their concerns/health needs. Excellent computer skills and attention to detail are very important to multitask between systems, talk with members on the phone, and enter accurate contact notes. This is a fast-paced position and productivity is important.
TRAVEL (30% or more) in the field to do member visits in the surrounding areas will be required. Remote in Tidewater, Central, SouthWest .Mileage will be reimbursed. Home office with internet connectivity of high speed required.
Schedule: Monday thru Friday 8:00AM to 5:00PM. - No weekends.

Must Have Skills:
KNOWLEDGE/SKILLS/ABILITIES
• Completes clinical assessments of members per regulated timelines and determines who may qualify for case management based on clinical judgment, changes in member's health or psychosocial wellness, and triggers from the assessment.
• Develops and implements a case management plan in collaboration with the member, caregiver, physician and/or other appropriate healthcare professionals and member's support network to address the member needs and goals.
• Conducts telephonic, face-to-face or home visits as required.
• Performs ongoing monitoring of the care plan to evaluate effectiveness, document interventions and goal achievement, and suggest changes accordingly.
• Maintains ongoing member case load for regular outreach and management.
• Promotes integration of services for members including behavioral health care and long term services and supports to enhance the continuity of care for *** members.
• May implement specific *** wellness programs i.e. asthma and depression disease management.
• Facilitates interdisciplinary care team meetings and informal ICT collaboration.
• Uses motivational interviewing and *** clinical guideposts to educate, support and motivate change during member contacts.
• Assesses for barriers to care, provides care coordination and assistance to member to address concerns.
• Collaborates with RN case managers/supervisors as needed or required
• Case managers in Behavioral Health and Social Science fields may provide consultation, resources and recommendations to peers as needed
• Local travel may be required, depending on the complexity level of the assigned members, particular state-specific regulations, or whether the Case Manager position is located within ***’s Central Programs unit.

Required Years of Experience: 1-3 years in case management, disease management, managed care or medical or behavioral health settings.
Required Licensure / Education: If license required for the job, license must be active, unrestricted and in good standing.
Must have valid driver’s license with good driving record and be able to drive within applicable state or locality with reliable transportation. Completion of an accredited Licensed Vocational Nurse (LVN) or Licensed Practical Nurse (LPN) Program OR Bachelor's or Master's Degree (preferably in a social science, psychology, gerontology, public health or social work or related, Or Graduate from an Accredited School of Nursing. Bachelor's Degree in Nursing preferred.
Comments for Suppliers: As of now positions are scheduled to last through end of June due to status of state contract. Might have another update by next week.