Care Manager Waiver (Sandusky/Seneca)

Insight Global; Dayton (OH); On-site; USD 55,000 - 75,000; Full time

Job summary

Insight Global seeks a Community Based Care Coordinator to coordinate care for Medicare/Medicaid eligible individuals living at home in Ohio. You will assess medical, behavioral, and social needs, craft personalized care plans, and connect members with housing, transportation, food assistance, and other community resources.

You will collaborate with physicians, ICTs, and community partners to ensure smooth transitions of care and reduce readmissions, while documenting progress and maintaining

Qualifications

• Must hold a current, unrestricted clinical license in Ohio in one of the listed disciplines.

Responsibilities

• Coordinate comprehensive member assessments across medical, behavioral health, and social needs.
• Develop and update individualized care plans and follow up post-hospitalization.
• Act as liaison between members, providers, and community organizations.
• Collaborate with interdisciplinary care teams to coordinate member care.
• Educate members and families on Medicare/Medicaid benefits and preventive care.
• Document interactions, care plans, and outcomes; ensure regulatory compliance.

Skills

Care coordination

Interdisciplinary teamwork

Patient education

Advocacy

Care plan development

Transitions of care

Education

RN license

ASN

Social Worker

Masters in Clinical Counseling

Masters in Social Work

Job description

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 their homes 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 and other community/neutral 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 programsEducate members and families on:Medicare and Medicaid benefitsChronic condition managementMedication adherencePreventive careAvailable healthcare and community servicesMonitor 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].