Community Based Care Manager
Core
Coordinate care and services for members through culturally competent delivery, creating person-centered care plans, and managing transitions between care settings to improve health outcomes.
Role type
Senior IC community-based care manager (case management)
Builds
Person-centered individualized care plans (ICP) and coordinated service delivery for members
Domain
Healthcare / Social Services / Case Management
Deliverable
client delivery
Required skills
Trauma-informed care, strength-based assessments, motivation interviewing, care coordination, case management, clinical standards implementation, resource identification, post-discharge planning, eligibility verification, psychosocial assessment
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 health and psychosocial assessments; facilitate inter-disciplinary care team meetings; develop and update person-centered care plans; coordinate with providers and community organizations for seamless care transitions; monitor progress and adjust interventions based on guidelines; document care activities and member response; provide clinical oversight to unlicensed team members.
Seniority
Senior, hands-on IC
