Complex Care Manager- Center

AbsoluteCare; Chicago (IL); On-site; USD 70,000 - 90,000; Full time

Job summary

AbsoluteCare recherche un Manager des soins complexes pour rejoindre son équipe de soins interdisciplinaires. Ce rôle implique la gestion de cas pour des membres ayant des besoins de santé complexes, en établissant des plans de soins personnalisés et en offrant une éducation ainsi que des interventions cliniques. La position requiert des visites sur site, à domicile et à distance, permettant une flexibilité dans les interactions avec les membres.

Qualifications

• Expérience de 3 ans avec des populations complexes.
• Compétences en communication excellentes pour interaction avec les membres.
• Capacité à évaluer les besoins psychosociaux.

Responsibilities

• Assurer les évaluations complètes et les plans de soins individuels.
• Coordonner les services avec les prestataires internes.
• Gérer la charge de cas en fonction de la fréquence de contact.

Skills

Communication

Gestion des cas

Intervention clinique

Travail en équipe

Education

Licencié(e) en soins cliniques (RN, LCSW, LMSW, etc.)

Tools

Microsoft Office

Dossiers médicaux électroniques

Job description

Join to apply for the Complex Care Manager- Center role at AbsoluteCare

This role is a member of the interdisciplinary care team (ICT), providing integrated case management for members with complex medical, behavioral, and social determinants of health needs. The CCM is assigned to an AbsoluteCare provider team. Members are assigned to the CCM based on health instabilities, utilization, and healthcare spend. The CCM completes a comprehensive assessment and creates a person-centered care plan that identifies and prioritizes health care goals with the member. The CCM supports members in meeting their goals through clinical interventions, education, motivational interviewing, self-management coaching, and complex case management services, including navigation of health plan benefits. The CCM coordinates services with internal providers, health plan programs, community resources, and specialists to meet the member’s individual needs and achieve value-based outcomes. The CCM is based at the comprehensive care center, with flexibility to conduct member visits via telephonically, telehealth, in-home, community, and other outpatient settings to support regular member engagement.

Duties and Responsibilities

1. Attend member visits at primary care or specialist offices and provide follow-up support for care coordination.
2. Complete comprehensive assessments and person-centered care plans (PCCP) for each member.
3. Manage care plans and member contact in compliance with agency requirements, protocols, and standards.
4. Develop, implement, and maintain PCCPs using SMART goals.
5. Keep PCCPs updated in the electronic health record, including measures to track progress.
6. Provide education with teach-back on health conditions, symptoms, and treatments.
7. Deliver evidence-based clinical interventions aligned with care plan goals, utilizing approaches like trauma-informed care, harm reduction, motivational interviewing, and problem-solving.
8. Meet Key Performance Indicators.
9. Manage caseload based on contact frequency and utilization data.
10. Provide crisis interventions as needed.
11. Address barriers to care to improve treatment adherence.
12. Collaborate with the ICT to update on member progress and needs, and recommend actions to stabilize health and address social determinants.
13. Assist members in accessing services and resources.
14. Document all interactions in the clinical system within 1 business day.
15. Participate in required meetings.
16. Follow up on service or resource referrals.

Minimum Qualifications

• Licensed clinician (RN, LCSW, LMSW, LMHC, LPC) in practicing state, with adherence to all laws and regulations. Preference for CCM credentialed candidates (e.g., CMGT-BC, CCTM, C-SWCM, C-ASWCM, ACM, FAACM). Candidates with other relevant credentials and experience may be considered.
• 3+ years of experience serving complex populations, including those with medical, trauma, mental health, substance abuse, and socioeconomic challenges.
• Willingness to travel to meet members in various settings, including outpatient, community, and specialist offices.
• Proficiency in Microsoft Office and electronic medical records.
• Excellent communication skills for interacting with members, families, stakeholders, and teams.
• Ability to meet accreditation and quality standards (e.g., NCQA, PCMH, HEDIS).
• Ability to work independently with sound clinical judgment.
• Valid driver’s license and proof of insurance.

Working Conditions

This position involves community and office work, requiring reliable transportation and routine use of office equipment.

Physical Requirements

• Effective communication skills.
• Ability to remain stationary for periods.
• Operation of computer and office equipment.
• Driving personal vehicle.
• Occasional lifting up to 20 lbs.

Direct Reports

None.

Seniority Level

• Mid-Senior level

Employment Type

• Full-time

Job Function

• Health Care Provider

Industries

• Hospitals and Healthcare

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