Case Manager, Medical

Sacramento Native American Health Center, Inc.; Sacramento (CA); On-site; USD 34,000 - 37,000; Full time

Job summary

The Medical Case Manager (CMC) at Sacramento Native American Health Center, Inc. provides comprehensive case management and care coordination for patients with complex physical, behavioral, dental, and social needs.

The role involves referrals, client interviews, data collection, and establishing care at SNAHC in collaboration with healthcare providers and community partners. This position requires strong communication, confidentiality, and the ability to work across programs.

Qualifications

• Experience providing case management for patients with complex needs.
• Ability to coordinate referrals and care plans.
• Knowledge of HIPAA and patient confidentiality.

Responsibilities

• Coordinate referrals to appropriate programs based on eligibility.
• Assist with durable medical equipment (DME) referrals and ensure productivity goals.
• Assess patients’ health status and create individualized care plans with short- and long-term goals.
• Maintain ongoing engagement with patients through in-person meetings, texts, and outreach.
• Document patient interactions and care plans accurately in records.
• Participate in care coordination meetings with dental and behavioral health departments.
• Track patient panels in the i2i system.
• Travel between SNAHC locations as needed.

Skills

Communication skills

Organizational skills

Microsoft Office

Confidentiality

Independent work

Professionalism

Cross-sector collab

Tools

Microsoft Office Suite

Job description

Here at SNAHC, you are joining a team and company at a time of growth and transformation. You will love being surrounded by people who are as passionate as you are about healthcare and giving back to the community. Please note that individual total compensation for this position will be determined at the Company's sole discretion and the wage range for this role considers a wide range of factors including but not limited to skill sets; experience and training; licensure and certifications; and other business and organizational needs. At SNAHC, it is not typical for an individual to be hired at or near the top of the range for their role and compensation decisions are dependent on the facts and circumstances of each case. A reasonable estimate of the current range is $25.00/HR-$27.00/HR.

Role may need to float to other SNAHC locations.

Position Summary

The Medical Case Manager (CMC) provides comprehensive case management and care coordination for patients with complex physical, behavioral, dental, and social needs. While primarily managing an assigned panel, the support provided extends to all patients as necessary. The CMC is responsible for referrals, client interviews, data collection, confidential record-keeping, client recruitment, and assisting with establishing care at SNAHC. This role involves close collaboration with program stakeholders, healthcare providers, healthcare payors, social services agencies, and other community-based organizations to ensure seamless coordination of services and patient support.

Essential Functions

• Coordinate referrals to appropriate programs based on eligibility criteria, patient needs, and provider assignment.
• Assists with durable medical equipment (DME) referrals for the medical department.
• Ensures productivity goals are met weekly.
• Assesses patients’ health status, regional resource utilization, and barriers to care to develop individualized care plans with short- and long-term goals.
• Maintains ongoing and effective engagement with assigned patients through in-person meetings, text/telephone communication, and community outreach.
• Provides in-person support to patients in waiting rooms and during appointments
• Ensure all patients have accurate and up-to-date shared care plans.
• Connects clients to a variety of services and resources to address their comprehensive needs.
• Participate in medical team huddles to enhance communication between the care team, partner outreach, and housing agencies.
• Maintains clear and timely documentation of all patient interactions, care plans, and outcomes in accordance with program requirements.
• Participates in care coordination meetings with dental and behavioral health departments for internal case conferences.
• Track patient panels in the electronic Population Health Management System (i.e., i2i).
• Collaborate with patients to follow organizational guidelines through non-judgmental and caring interactions.
• Support quality improvement initiatives in accordance with the organization's mission and strategic goals, federal and state laws and regulations, and accreditation standards.
• Comply with all state and federal laws and regulations, including HIPAA, sexual harassment, scope of practice, OSHA, etc.
• May be required to travel between sites for coverage and/or meetings.
• Other duties as assigned.

Skills And Abilities

• Excellent computer skills, preferably with Windows, including Microsoft Office Suite
• Excellent telephone and communication skills
• Must possess excellent organizational, writing, and verbal skills.
• Ability to work independently, set priorities, and work well under pressure.
• Ability to maintain a high degree of confidentiality
• Ability to demonstrate superior professionalism when dealing with patients, subordinates, colleagues, community members and vendors.
• Ability to collaborate and convene across sectors and organizational levels.

Competencies

• Communication and Relationships
• Initiative
• Planning and Organizing
• Safety
• Teamwork
• Program Specific Workflows