Community Based Care Managers
Core
Coordinate care and services for members through culturally competent delivery, assessments, and person-centered care planning to address behavioral, physical, and social determinants of health.
Role type
Senior IC community-based care manager (case management)
Builds
Individualized care plans and coordinated service delivery for health plan members
Domain
Healthcare / Social Services / Public Health
Deliverable
production ML models | product features | dashboards & analysis | research | client delivery | infrastructure | physical/clinical work
Required skills
Trauma-informed care approach, Strength-based assessments, Motivation interviewing, Health equity lens, Inter-disciplinary team facilitation, Person-centered care planning, Barrier identification, Intervention implementation, Care coordination, Eligibility verification, Psychosocial and behavioral assessment, Post-discharge transition planning, Resource coordination, Clinical oversight
Preferred skills
Medicaid/Medicare managed care experience, Case Management Certification, Advanced clinical degree
Technologies
Microsoft Office (Outlook, Word, Excel)
Responsibilities
Engage members and support systems for strength-based assessments; Facilitate inter-disciplinary care team meetings; Develop and update person-centered individualized care plans; Identify and manage barriers to care goals; Educate members on treatment options and community resources; Monitor and promote effective utilization of healthcare resources; Coordinate with community organizations and state agencies; Adjust intervention intensity based on member progress; Provide clinical oversight to unlicensed team members; Document care coordination activities; Conduct regular travel for member and provider visits.
Seniority
Senior, hands-on IC
