Care Manager (Logan)

Insight Global; Dayton (OH); In loco; USD 60.000 - 80.000; Tempo pieno

Descrizione del lavoro

Insight Global is seeking a Community Based Care Coordinator to manage care for individuals eligible for both Medicare and Medicaid. The role involves assessing medical, behavioral, and social needs, designing individualized care plans, and coordinating with healthcare providers and community organizations.

The position requires an Ohio unrestricted clinical license (RN/ASN/Social Worker/Clinical Counselor) and experience in care coordination.

Competenze

• Must hold a current, unrestricted clinical license in Ohio (RN, ASN, Social Worker, Masters, Clinical Counselor).
• Experience coordinating care for Medicare/Medicaid-eligible populations is preferred.
• Ability to work with interdisciplinary teams and community-based organizations.

Mansioni

• Coordinate care for individuals eligible for both Medicare and Medicaid.
• Assess medical, behavioral, functional, and social needs and develop care plans.
• Meet members in their homes or community settings and connect with resources.
• Collaborate with physicians, providers, and state agencies to coordinate care.
• Coordinate transitions of care and follow up to prevent readmissions.
• Document interactions, care plans, interventions, and outcomes accurately.

Conoscenze

Care coordination

Assessment

Interdisciplinary teamwork

Communication skills

Formazione

Ohio clinical licensure (RN/ASN/MSW/Clinical Counselor)

Descrizione del lavoro

Job Description

The Community Based Care Coordinator is responsible for coordinating care for individuals who are eligible for both Medicare and Medicaid. This role works directly with members living in longer term care facilities to assess medical, behavioral, and social needs, develop individualized care plans, connect members with resources, and coordinate care across providers and community organizations.

Main Responsibilities

Conduct comprehensive member assessments to identify medical, behavioral health, functional, and social needs. Develop, implement, and regularly update individualized care plans. Meet with members in their homes, healthcare settings, offices, and other community locations. Serve as a liaison between members, healthcare providers, community organizations, and other service agencies. Lead and collaborate with interdisciplinary care teams (ICTs) to coordinate member care. Coordinate transitions of care and follow up after hospitalizations or significant health events to help prevent readmissions. Connect members with community resources, including:

• HousingTransportationFood assistanceSocial servicesOther community-based programs

Educate members and families on:

• Medicare and Medicaid benefits
• Chronic condition management
• Medication adherence
• Preventive care
• Available healthcare and community services

Monitor member progress, health status, and adherence to the care plan. Collaborate with physicians, specialists, behavioral health providers, state agencies, and community-based organizations. Advocate for members and encourage active participation in healthcare decisions. Maintain accurate documentation of member interactions, care plans, interventions, and outcomes. Identify and address barriers to care. Report suspected abuse, neglect, or exploitation as a mandated reporter when required. Maintain compliance with applicable NCQA and CMSA standards

Skills and Requirements

Must have a current, unrestricted clinical license in Ohio as one of the following:

• Registered Nurse (RN)ASNSocial WorkerMastersClinical CounselorMasters

Experience

Must have experience in a healthcare-related profession, such as:

• NursingSocial WorkCounselingCase ManagementCare CoordinationDischarge PlanningHome HealthCommunity Health Management

Additional Requirements

Candidates must also have:

• Valid driver's licenseReliable vehicleVerifiable auto insuranceAcceptable driver's license recordExperience working with dual-eligible Medicare/Medicaid populationsExperience with Medicaid and/or Medicare managed careStrong understanding of Medicare and Medicaid programsKnowledge of community resources available to high-risk or complex populationsExperience developing and managing individualized care plansExperience collaborating with interdisciplinary healthcare teamsExperience conducting assessments in members' homes or community settingsCase Management Certification, highly preferred

We are a company committed to creating diverse and inclusive environments where people can bring their full, authentic selves to work every day. We are an equal employment opportunity/affirmative action employer that believes everyone matters. Qualified candidates will receive consideration for employment without regard to race, color, ethnicity, religion, sex (including pregnancy), sexual orientation, gender identity and expression, marital status, national origin, ancestry, genetic factors, age, disability, protected veteran status, military or uniformed service member status, or any other status or characteristic protected by applicable laws, regulations, and ordinances.

If you need assistance and/or a reasonable accommodation due to a disability during the application or the recruiting process, please send a request to [e-mail].