Community Based Care Manager Macomb and Wayne Cou

$50,000 - $70,000/Yr

CareSource Management Services - Detroit, MI

Full-time - Entry Level

Detroit, MI

About the position

The Community Based Care Manager plays a crucial role in collaborating with an inter-disciplinary care team to enhance the quality of care for members. This position focuses on culturally competent delivery of care and coordination of services, ensuring that individual needs are met through effective communication and planning. The manager will engage with members and their support systems to create and evaluate person-centered care plans, addressing behavioral, physical, and social determinants of health to improve overall member outcomes.

Responsibilities

• Engage members and their support systems through strength-based assessments and a trauma-informed care approach.
• Facilitate regularly scheduled inter-disciplinary care team (ICT) meetings to address member needs.
• Establish effective professional relationships with members in various settings, including hospitals and community agencies.
• Develop individualized care plans in collaboration with the ICT based on member preferences.
• Identify and manage barriers to achieving care plan goals.
• Implement effective interventions based on clinical standards and best practices.
• Empower members to manage their health and wellness through effective care coordination.
• Facilitate communication and collaboration with the ICT to maximize positive member outcomes.
• Educate members and their supports about treatment options and community resources.
• Conduct ongoing assessments and document member progress on care plans.
• Evaluate member satisfaction and address concerns or issues.
• Monitor healthcare resource utilization and manage clinical variance.
• Verify member eligibility and health status through comprehensive assessments.
• Oversee timely psychosocial and behavioral assessments and care planning.
• Participate in provider meetings to inform them of available Care Management services.
• Assist with training for facility and community providers on the ICDS model of care.
• Identify and address gaps in care and access for members.
• Coordinate with community-based case managers to avoid duplication of services.
• Terminate care coordination services based on established guidelines when necessary.
• Provide clinical oversight to unlicensed team members as appropriate.
• Document care coordination activities in accordance with CareSource policies.
• Continuously assess and improve processes to enhance member experience.
• Travel regularly to conduct member and provider visits as needed.

Requirements

• Nursing degree from an accredited nursing program or Bachelor's degree in a health care field or equivalent experience is required.
• Licensure as a Registered Nurse, Professional Clinical Counselor, or Social Worker is required.
• Advanced degree associated with clinical licensure is preferred.
• A minimum of three (3) years of experience in nursing, social work, counseling, or healthcare profession is required.
• Three (3) years of Medicaid and/or Medicare managed care experience is preferred.

Nice-to-haves

• Advanced degree associated with clinical licensure.
• Experience in discharge planning, case management, or home/community health management.

Benefits

• Competitive salary range of $50K to $70K.
• Full-time employment with a focus on veteran and disability inclusion.