Miami, Florida
Non-Clinical Care Manager Job Opening in Miami, Florida - The Non-Clinical Care Manager is responsible for non-clinical care management services of members enrolled through ILS? client health plans to promote effective education, self-management support, and timely healthcare delivery to achieve optimal quality and positive outcomes. The Non-Clinical Care Manager behaves in a professional manner, and consistently demonstrates and promotes the values of respect, honesty, care and dignity for the members as well as all other team members involved in the servicing of ILS? clients. The Non-Clinical Care Manager is involved in care management services for the diverse member population that ILS services. The Non-Clinical Care Manager will be responsible for working in conjunction with the Clinical Care Manager in the collaborative development and ongoing maintenance of individualized care plans using available clinical, social and functional data.
POSITION RESPONSIBILITIES AND ACCOUNTABILITY
Conducts review of member?s care plan to ensure needs are identified and included onto the member?s individualized care plan.
Interacts telephonically with member to maintain member?s individualized care plan using the available data.
Prioritizes members according to intensity, need, and required follow-up.
Conducts periodic assessments and alerts Clinical Care Manager of clinical needs or changes to member?s care plan.
Evaluates the effectiveness of the care plan in meeting established care goals; revises the non-clinical components of the care plan as needed to reflect changing needs, problems, and goals.
Identifies and effectively utilizes health plan benefits and community resources to meet the needs of members and caregivers.
Makes appropriate referrals to other programs to address the member?s needs.
Promotes member self-management and empowers members/caregivers to achieve maximum levels of wellness and independence.
Provides ongoing development of non-clinical components of the care plan using the problems, goals and interventions methodology for assigned case load.
Serves as a liaison to providers, members and caregivers for coordination of services.
Provides member with non-clinical education during care management activities
Maintains accurate and timely documentation in the electronic care management system.
Participates in interdisciplinary care team meetings and case conferences as needed
Participates in orientation of new personnel.
Participates in regular team meetings and departmental in-services
Works in conjunction with others on the team and promotes collaborative teamwork
Adheres to organizational policies and procedures.
Maintains a working knowledge of, and adheres to applicable federal/state regulations including but not limited to, laws related to patient confidentiality, release of information, and HIPAA.
Maintains appropriate professional boundaries.
Uses safe work practices. Promptly reports workplace and patient safety issues to supervisor.
Interacts in a manner, which is professional, respectful, positive, helpful, and promotes trust.
Maintains professional growth and development.
Complies with all requirements of the Care Management Model of Care.
POSITION QUALIFICATION
Minimum Education:
v Baccalaureate Degree in healthcare related field.
Minimum Experience:
v 1+ years in healthcare related field
v 1+ years in care management preferred
v 1+ years in managed healthcare preferred
Other:
v Basic computer skills including data entry (database), MS Word.
v Strong communication skills including verbal and writing skills
v Valid Driver?s License
v Ability to work independently, while collaborating with other team members
Job Type: Full-time
Required education:
Bachelor's
Required experience:
Healthcare: 1 year
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