Lead Care Manager Job Summary: The Lead Care Manager (LCM) is responsible for case management of members and their families in obtaining and understanding services and programs available through the Enhanced Care Management (ECM) program. The Lead Care Manager is tasked with improving their health and overall well-being through our services. The Lead Care Manager is an energetic self-starter who can function comfortably in a team environment and independently and relates well to co-workers and external representatives.
Essential Functions:
The Lead Care Manager is responsible for an assigned caseload of adult and pediatric members. The Lead Care Manager will conduct comprehensive assessments to determine the physical, emotional, and social needs of members.
Care Planning: Develop individualized care plans based on assessment findings, considering medical history, preferences, and specific needs. Care Plans should be tailored to individual needs and goals.
Coordination: Coordinate and facilitate communication between healthcare providers, social workers, therapists, and other members of the care team to ensure a comprehensive and integrated approach to care. Collaborate with Medical Doctors, Clinical Consultants, Housing Navigators and Leaders to make recommendations tailored to the members' needs.
Monitoring: Continuously monitor the progress of members and update care plans as needed per policy and compliance requirements. Ensure that prescribed treatments and interventions are being followed and communicate to PCP and specialty care providers any significant changes to member's concerns along with any updates on member's status.
Member Experience: Provide positive member client service experience through multiple support channels including telephone and in-person. The Enhanced Care Management program is high touch and in person centered.
Documentation: Maintain accurate and up-to-date records of assessments, care plans, and interactions with members. Ensure compliance with relevant regulations and standards. Complete all required documentation accurately, in a timely manner and in accordance with company standards. Provide leaders with case progress periodically/required basis.
Advocacy: Serve as an advocate for patients or clients, helping them navigate the healthcare system, understand their treatment options, and access the services they require.
Education: Provide education to members and their families on health-related topics, treatment options, and self-care strategies.
Resource Referral: Identify and connect members with appropriate community resources, support services, and programs to address their needs, such as housing assistance, financial aid, or counseling services.
Assist with Discharge Planning: Help plan and coordinate the discharge process for members leaving hospitals or long-term care facilities, ensuring a smooth transition to home or another care setting.
Opportunity to participate in training new employees.
Performs other duties as assigned or required per departmental policy.
Qualifications:
Education & Experience: Associate Degree and 2 years of healthcare or care coordination experience.
Language: Fluent in English (written and verbal).
License/certification:
Current and valid Driver's License and proof of auto insurance. o Current BLS certification from the American Heart Association upon start date.
Skills required:
Competent with computers, email, virtual platforms, Excel and other Microsoft Office based programs.
Prior use of Electronic Medical Records.
Excellent verbal and written communication skills, including the ability to convey and exchange information in a clear, effective manner.
Ability to identify problems and use logic and related information to develop and implement solutions.
Ability to work independently and carry out assignments to completion within the parameters of established policies and procedures.
Expected Hours of Work:
Monday- Friday 8:30am to 5:00pm.
Salary:
Pay Range: $23 - $28 per hour.
Travel:
This is a hybrid role.
Eligible for mileage reimbursement for the use of your vehicle for business-related expenses.
Physical Requirements: Physical demands associated with office work and driving, including but not limited to:
Consistently operating a computer and other office equipment such as a telephone, calculator, copy machine, and printer.
Must be able to remain in a stationary position 30% of the time.
Must be able to move around the office or community 70% of the time.
Frequently moving or carrying office equipment weighing up to 15 pounds across offices.
Ability to operate a vehicle and travel to meet with assign
Benefits:
This is a hybrid role working from home while still servicing members in person!
Medical, Dental and Vision Insurance
We cover up to 100% of your premium and 50% of your dependent premium depending on the plan!
Flexible Spending Accounts, Health Savings Accounts & Dependent Care Accounts are also available!
Life, AD&D and Short-Term Disability Insurance funded 100% by Titanium Healthcare
401(k) plan
Employee Assistance Program
12 Paid Holidays, 3 weeks of all-inclusive PTO per year (accrual begins on the first day of employment) as well as a separate Paid Sick Time balance
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