*This position will require employees to be in the field (D.C) four (4) days a week and 1 day remote. Under the direction of the Senior Care Manager, the Care Manager (CM) is responsible for providing comprehensive care coordination services to members who are enrolled in the health plan. The CM routinely communicates with members on their assigned caseload to assess their needs; develop, monitor and evaluate treatment plan progress; and assist with coordinating care and referring to appropriate services for members who have moderate to complex medical and psychosocial needs. Essential job duties Manages a caseload as outlined and Care Management Leadership. Maintains compliance in accordance with contractual and care management requirements Contacts enrollee at predetermined intervals based on stratification level or more frequently, as needed. Conducts face-to-face visits at a frequency determined by the enrollee's assigned stratification level or more if needed, with each enrollee/caregiver in their homes, physician's offices, or other mutually agreed upon locations. Assesses enrollees on enrollment and at intervals determined by the enrollee's stratification level to identify needs/barriers and close gaps in care. Identifies over/under utilization promptly, and takes appropriate action according to organizational policy.
Qualifications:
Master's Degree (Required)DC LICSW (Required)3 years or more years of healthcare or related experience in managed care and /or care management (Required)3 years or more years experience in clinical or community resource settings (Required)
