Community Engagement and Complex Case Manager I - King Region

$83,710 - $131,420/Yr

Community Health Plan Of Wa - Seattle, WA

Full-time - Mid Level

Seattle, WA

About the position

The Community Engagement and Complex Case Manager I position at Community Health Plan of Washington is responsible for coordinating care management services for members with complex medical, behavioral, and social conditions. This role involves advocacy, collaboration with healthcare providers, and representation of the organization in regional meetings. The position requires a blend of remote and field work within the King County region, focusing on reducing health disparities and promoting an equitable work environment.

Responsibilities

• Coordinate all case management services within assigned areas to ensure appropriate service delivery to CHPW members.
• Perform assessment, planning, facilitation, and advocacy through collaboration with members and healthcare resources.
• Represent CHPW Care Management Department at regional meetings and prepare presentations for stakeholders.
• Collaborate with leadership for presentation preparation and follow up on commitments from meetings.
• Work with providers and community resources to implement programs and monitor health outcomes of case-managed members.
• Conduct assessments and review appropriateness of care levels, participating in clinical outcome data collection.
• Develop interdisciplinary care plans in conjunction with members' healthcare providers and community resources.
• Coordinate continuity of care with utilization management and discharge planning teams.

Requirements

• Bachelor's degree in nursing or a master's degree in social work or related behavioral health field (required).
• Current, unrestricted license in Washington as a registered nurse (RN) or as a Social Worker (LSWAA, LSWAIC) or as a Mental Health Counselor (LMHC), Mental Health Professional (LMHP), or Marriage and Family Therapist (LMFT) (required).
• Minimum of one (1) year of case management experience (required).
• Minimum of two (2) years of experience with care management workflow systems and NCQA standards (required).

Nice-to-haves

• Case management certification
• Bilingual
• Experience in managed care (Medicaid/HCA)
• Experience using Care Management software applications
• Knowledge of community resources

Benefits

• Paid jury duty
• Health savings account
• AD&D insurance
• Disability insurance
• Health insurance
• Dental insurance
• Flexible spending account
• Paid time off
• Employee assistance program
• Vision insurance
• 401(k) matching