Care Manager - Active
Job Details

Under the supervision of the Care Management (CM) Supervisor, the Care Manager I is responsible for completing the appropriate level of care management activities for Rocky Mountain Human Services (RMHS) clients. Care management activities will include but will not be limited to completing assessments, determining eligibility, monitoring provider services, coordinating services, developing care plans, delivering care management interventions, appropriate follow up activities and completing all documentation in the expected time frame. The Care Manager I will apply appropriate criteria, guidelines, regulations specific to the level of care and services required to meet the member/family goals and the organizational/contractual requirements. Care management functions may be performed for clients in a variety of settings including telephonic, in-person or in the community setting.

 

Essential Duties

  • Completes mandatory and needs based health assessments to identify client strengths, needs, concerns and preferences through interviewing, observing, and utilization of standardized tools.
  • Establishes person centered goals and a plan of care with the client and their natural supports/family members.
  • Provides care coordination services and interventions by referring, educating, negotiating, and mediating with the client and external providers of client services.
  • Educates clients regarding various state plan benefits, programs, options and services.
  • Monitors client status and satisfaction with services and makes adjustments to care plan as needed.
  • Monitors the ongoing provision of and need for care by assessing the delivery and quality of services and interventions provided by external providers.
  • Establishes professional and effective collaboration, communication, and coordination among all responsible parties of an individual members interdisciplinary health care team.
  • As needed, attends client focused meetings (internal/external) to facilitate changes in services or collaborate in care.
  • Maintains knowledge of regulations, policies, and procedures regarding current public assistance programs.
  • Assists clients and providers in understanding the complaint, grievance and appeal process.
  • Responsible for accurate and timely completion of all forms, reports, and documentation of care management activities.
  • Maintains professional and ethical manner with all interactions and meets performance, quality, customer service, and coordination standards as assigned by the department management team.
  • Participates in training and staff development opportunities. Actively participates in team meetings and communicates progress and barriers with Supervisor and/or Program Manager or Department Director.

 


 

Knowledge, Skills and Abilities

  • Ability to process high volume of work efficiently with a high level of customer service detail.
  • Knowledge of and ability to relate to populations served by the programs for which we work, client interviewing and assessment skills, knowledge of policies and procedures regarding public assistance programs, ability to develop care plans and service agreements, knowledge of resources, and negotiation, intervention, and interpersonal communication skills.
  • Demonstrates support for the companys mission, vision and values.
  • Excellent written and verbal communication skills, strong organizational and time management skills, strong interpersonal skills and the ability to handle multiple priorities.
  • Ability to work independently outside of office setting and conducting face to face assessment visits. Must have general computer skills and ability to work with Microsoft Office products.
  • Ability to use the complaint, grievance and appeals process and procedures to facilitate quality outcomes and/or resolutions for clients.
  • May be required to manage multiple priorities and projects with tight deadlines.
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