Roanoke, Virginia
Care Coordinator- Full time Job Opening in Roanoke, Virginia - The Care Coordinator provides case management functions for members enrolled through ILS? client health plans to assist in promoting effective education, self-management support, and timely healthcare delivery to achieve optimal quality and positive outcomes. The Care Coordinator 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 Care Coordinator is involved in care management support services inclusive of Elderly and Disabled with Consumer Direction (EDCD) and Nursing Facility waiver programs. The Care Coordinator works to support the care management model including coordination, with other ILS and Health Plan Personnel and/or their partners. The Care Coordinator is responsible to ensure members are assessed per ILS policies and contractual requirements; plans of care are developed with the member that are focused on their individual needs; and timely documentation of all coordination activities in eCare.
POSITION RESPONSIBILITIES AND ACCOUNTABILITY
Contacts members within required time frames & conduct assessments
Follows policies on contacting members that are unable to be reached
Prioritizes members according to intensity, need, and required follow-up. Schedules visits/contacts using most efficient routing/time efficiency as possible
Conducts comprehensive assessments utilizing eCare tools & incorporates other required Health Plan &/or State/Federal required assessments..
Collaborates with member to develop a patient centered plan of care that incorporates a service plan, back up plan and identification of problems, goals & intervention.
Makes appropriate referrals to other programs to address the member?s needs in keeping with State Service Cost Maximums &/or utilizing plan benefits; incorporates natural supports & community resources as appropriate
Insures care coordination activities and all communication is documented accurately and timely in eCare and/or in any required Health Plan or State reporting required format to insure that information will be available for any needed report production, data collection and data entry for care plan management.
Initiates and collaborates with the interdisciplinary care team (ICT) and facilitates case reviews as necessary.
Identifies members who are candidates for participant directed/self directed care and educates the member on the process.
Identifies nursing facility residents who are candidates for transitional services and collaborate with the member, facility staff and community agencies to transition members as possible
Provides ongoing communication and information to their manager
Participates in orientation of new personnel
Participates in regular team meetings and ongoing education
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. Interacts in a manner, which is professional, respectful, positive, helpful, and promotes trust.
Uses safe work practices. Promptly reports workplace and patient safety issues to supervisor.
Serves as an advocate for their member alert to any possibility of abuse, neglect &/or exploitation & any situation where fraud & abuse may occur; follows reporting guidelines
Maintains professional growth and development
Facilitates transitions of care from hospital to home/NF ensuring appropriate discharge planning & interventions to lessen risk of readmission
Participates in on-call rotation responding to any after hour member inquiries, responding as required & documenting intervention(s) in ecare; reports any occurrences to the manager the next business day
POSITION QUALIFICATIONS
RN Preferred,
Social Worker, VA licensed & Masters preferred
Variety of backgrounds: physically disabled, elderly, brain injured, HIV/Aids with experience in various settings: home health, long term care, community care, rehabilitation, medical management
Valid driver?s license, reliable car with current insurance
Microsoft Office, ability to toggle between screens, tablet skills & ability to type & talk simultaneously.
EOE
Job Type: Contract
Job Type: Contract
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