Community Care Coordination Manager

4 weeks ago

Canada CareSource Full time

Position Overview:

The Community Care Coordination Manager works collaboratively with an inter-disciplinary care team (ICT), healthcare providers, and community organizations to enhance service quality and address the unique needs of individuals and populations through culturally sensitive care delivery and service coordination. This role is pivotal in facilitating communication, coordinating care, and supporting members through comprehensive assessments, planning, and the development of personalized care strategies that prioritize behavioral, physical, and social health determinants.

Key Responsibilities:

  • Engage members and their support systems using strength-based assessments and a trauma-informed approach, employing motivational interviewing techniques to conduct health and psychosocial evaluations that consider cultural and social factors affecting health.
  • Organize and lead regular inter-disciplinary care team meetings to address member needs effectively.
  • Establish professional relationships with members in various settings, including hospitals, community agencies, and through telephonic or electronic communication.
  • Collaborate with the ICT to create individualized care plans that reflect the member's preferences and needs.
  • Identify and mitigate barriers to achieving care plan objectives.
  • Implement effective interventions aligned with clinical standards and best practices.
  • Empower members to enhance their health and well-being through effective care coordination and management.
  • Facilitate communication and collaboration among the member, ICT, and other stakeholders to achieve desired outcomes.
  • Educate members and their support systems about treatment options, community resources, and insurance benefits to enable informed decision-making.
  • Conduct ongoing assessments and document member progress in relation to their care plans.
  • Monitor member satisfaction through open communication and address any concerns promptly.
  • Ensure efficient use of healthcare resources through clinical variance management.
  • Verify member eligibility and health status, and complete necessary assessments by gathering information from various stakeholders.
  • Coordinate with facility-based case managers to plan for post-discharge needs and facilitate transitions to appropriate care levels.
  • Collaborate with community-based case managers to ensure service coordination and prevent duplication.
  • Provide guidance and oversight to unlicensed team members as necessary.
  • Document care coordination activities in accordance with professional standards and organizational policies.
  • Regularly assess processes for improvement to enhance member experiences.
  • Travel as required to conduct visits with members, providers, and community organizations.
  • Adhere to relevant standards and regulations in all aspects of care management.

Qualifications:

  • A nursing degree from an accredited program or a Bachelor's degree in a healthcare-related field, or equivalent experience is required.
  • Current licensure as a Registered Nurse, Professional Clinical Counselor, or Social Worker is mandatory.
  • Advanced clinical degree is preferred.
  • At least three years of experience in nursing, social work, counseling, or healthcare management is required.
  • Experience in Medicaid and/or Medicare managed care is preferred.

Skills and Competencies:

  • Strong understanding of quality metrics, disease management, and medication adherence.
  • Proficient in Microsoft Office applications.
  • Excellent communication skills with diverse populations.
  • Ability to manage multiple tasks and work independently within a team.
  • Knowledge of healthcare laws and regulations related to case management.
  • Commitment to ethical practices in professional conduct.
  • Advocacy for members across all levels of care.
  • Awareness of community resources and support systems.
  • Strong organizational and time management abilities.

Working Environment:

  • This role requires regular travel to various locations, including member homes and community settings.
  • Flexible working hours may be necessary to meet member needs.

Compensation:
$60,000 - $96,500. Compensation is based on a combination of education, experience, and the complexity of the role.

CareSource Commitment:
CareSource is dedicated to fostering a diverse and inclusive workplace. We are an Equal Opportunity Employer.

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