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Care Manager-Source

COLUMBUS MEDICAL SERVICES LLC • Full-time • Remote (GA, US) • 1w ago

Travel/Work Environment

This field-based position is responsible for serving clients throughout Brooks and Lowndes Counties in Georgia and requires frequent travel within the assigned service area. Candidates must reside in Georgia, preferably within or near the counties they support, and will complete administrative work remotely when not conducting client visits.

Must have and maintain a valid state driver’s license, automobile insurance coverage, and access to an automobile.

Work is performed in a variety of settings, including client homes, community settings, and office environments.

Summary of position

The Care Manager is responsible for coordinating individualized Plans of Care and Service Plans for participants. This includes assisting with the selection of service providers and establishing necessary authorizations. Key responsibilities involve monitoring service delivery through consistent communication with participants and their caregivers, conducting outreach as needed based on contractual obligations or changes in the participant's health, and screening for any health or condition changes. The Care Manager also escalates cases that need clinical expertise, reports potential Critical Incidents, and collaborates in interdisciplinary meetings, discharge planning, and transition activities with the care team. Care Manager may assist with routine client visits as needed to support Nurse Case Managers in ensuring timely and comprehensive care delivery.

Essential Functions

Create, coordinate, and implement comprehensive Plans of Care and Service Plans for participants.

Collaborate with healthcare providers, participants, and their families to ensure the Plan of Care addresses all medical, social, and personal needs.

Monitor and verify the delivery of services as specified in the Plan of Care.

Ensure that all services are provided efficiently, effectively, and in accordance with established standards.

Conduct monthly phone visits with participants, or more frequently as needed based on stratification levels.

Assess participants' needs, progress, and satisfaction during these visits, updating person-centered Plans of Care and Service Plans as necessary.

Offer support and guidance to participants and their families, addressing any concerns or issues related to care and services.

Educate participants and families about available resources and services.

Maintain accurate and current documentation of all interactions with participants, including phone visits, service delivery confirmations, and updates to Plans of Care.

Prepare and submit reports as required by regulatory agencies and organizational policies.

Ensure that all care management activities adhere to relevant regulations, organizational policies, and best practices.

Participate in audits and reviews to ensure compliance and quality of care.

Collaborate closely with healthcare providers, social workers, and other professionals to coordinate and enhance care for participants.

Attend interdisciplinary team meetings to discuss participant progress and care plans.

Refer individuals to Transition Specialists, Behavioral Health Care Management, Member Resource Administrators, and Clinical Intake Specialists for additional coordination of benefits or transition activities.

Assist with routine client visits, as needed, to support Nurse Case Managers in ensuring timely and comprehensive care delivery.

Position Requirements

Requires a Bachelor's degree in social work, sociology, psychology, or a related field.

Requires two(2) years experience in the human service or health related field

Experience and skills in conducting person-centered assessments and developing service plans.

Knowledge of human behavior, gerontology

Knowledge of community organization and service system development

Knowledge and skill in social and health service intervention

Experienced in problem solving, analyzing situations, evaluating information, and recommending appropriate actions.

Skills, Knowledge & Abilities

Proficient in utilizing automated information systems for data entry, updates, modifications, retrieval, and reporting.

Adept at building and maintaining supportive relationships with individuals and families, demonstrating strong interpersonal and assistance skills.

Highly self-motivated with a strong sense of initiative, accountability, and follow-through.

Strong analytical skills, including problem definition, data collection, fact-finding, and drawing valid conclusions.

Experienced in Microsoft Office Suite (Word, Excel, PowerPoint).

Skilled in interpreting and applying policies, procedures, and regulations.

Experienced in evaluating situations, analyzing information, and recommending appropriate actions.

Effective at fostering collaborative relationships with colleagues and external partners.

Capable of assessing issues and clearly explaining rules and guidelines.

Proficient in drafting detailed reports, correspondence, and professional documentation.

Strong presentation skills, with the ability to convey information and respond to questions from managers and teams.

The job description is not designed to cover or contain a comprehensive listing of activities, duties or responsibilities that are required of the employee. Other duties, responsibilities and activities may change or be assigned at any time.