Case Manager, One Care

SUMMARY:

The Case Manager One Care will provide case management, concrete follow-up, advocacy and interpreter services (as appropriate) in order to coordinate services, facilitate and improve access to ongoing primary health care for members of One Care program. This position will work very closely with One Care staff within the healthcare teams and multi-agency One Care team to address patient medical needs and ensure program is on track to meet both contract requirements and outcome measures.

 

CORE RESPONSIBILITIES:

  • Respect and maintain patient confidentiality in all aspects of care including use of electronic information.
  • Treat all patients in a welcoming and professional manner.
  • Demonstrate professionalism by appropriate attire, attendance, attitude, and behavior within the clinical setting.
  • Contributes to the team effort by supporting all team members and maintaining an open and positive attitude.
  • Welcome new employees to the team by assisting with their orientation to the team and mentoring them as requested.

SPECIFIC DUTIES AND RESPONSIBILITIES:

Provides general administrative and clinical office support to One Care clinical staff:

      • Faxes appropriate documents to vendors, providers, and Commonwealth Care Alliance office.
      • Files administrative paperwork and medical record documentation according to policy and procedure.
      • Facilitates the ordering of services for members under the direction of Clinician, including faxing or phone calls.
      • Serves as liaison to vendors and clinical staff regarding certified services; answering basic questions regarding type and duration of authorized services; refers all other questions to One Care manager and rest of multi-agency team, as appropriate.
      • Communicates with the CCA program on a regular basis regarding program activities and processes.  This includes attending CCA meetings.
      • Provides outreach support to Team as needed
      • Ensuring new hires are set up with CCA orientation and training.
      • Updates care teams as patients are enrolled
      • Assists to assign new Members to appropriate Care Partner
      • Outreach efforts include managing referral workqueue, identifying qualifying patients and notifying providers, completing new applications, assisting with re-enrollments, presenting program to new onboarding providers.
      • Assists members with transportation to appointments as needed.
      • Reconciles CCA quarterly reports
      • Tracks, schedules and reports on  annual comprehensive physical assessments.  Tracks and reports on MDS completion, post hospital visits completion, LTSC cases, for members.
      • Facilitates the updating of reporting and tracking systems with clinical and administrative One Care staff.
      • Files appropriate documentation in the member’s CCA medical record (both hard copy and electronic) according to policy and procedure.

Provide clients with culturally appropriate services depending on individual needs and preferences

These include but are not limited to:

  • Problem solving within the health center and with other agencies, as needed
  • Client support and advocacy
  • Informal encouragement
  • Direct practical assistance, i.e. filling out forms, making appointments
  • Follow up contact
  • Communication with clients’ primary care or behavioral health providers coordinating/providing interpreter services
  • Responsible for ongoing monitoring, follow up and discharge planning, as appropriate
  • Provide feedback to providers regarding patient activity
  • Keep logs, statistics of consumer contacts, as required by funding source

SUPERVISION/MEETINGS:

  • Attend One Care Team meetings.
  • Attend meetings with One Care Manager and RN Care Managers as needed

CUSTOMER SERVICE:

  • Demonstrates an understanding of customer service principles by successfully completing on-line Customer Service Training
  • Utilizes the principle of customer service when interacting with patients/clients, team member, and staff from other departments
  • Appropriately handles or seeks support when customer service breakdowns occur

CULTURAL COMPETENCE:

  • Demonstrates knowledge of culture by successfully completing the on-line training on Cultural Competence.
  • Utilizes an appreciation of and respect for diversity when interacting with patients/clients, team members and staff from other departments.
  • Responds appropriately or seeks support when confronted with cultural biases or conflicts.

EMERGENCY SITUATIONS:

In order to respond promptly and appropriately to emergency situations, any staff member may be assigned temporary duties which differ from those in the job description, or may be assigned temporarily to a different location or schedule.

Requirements

QUALIFICATIONS:

  • Two or more years experience performing a variety of administrative support functions. 
  • Experience with contact and outreach to a variety of patients with various healthcare needs. 
  • Ability to prioritize workload and manage multiple projects simultaneously and problem solve with minimum supervision is required.  
  • Proficiency in word processing, Excel, Access and other computer office software knowledge strongly preferred.
  • Well-organized and able to communicate effectively with individuals and groups. 
  • Bilingual in Spanish strongly preferred.
  • History of good attendance and positive work attitude.

SPECIAL REQUIREMENTS:

  • The essential duties of this position present risk of exposure to airborne infection, body fluids, and blood-borne pathogen. 
  • Annual BBP training is required. 
  • Up to date immunization and annual TB testing is required. 
  • Hepatitis B vaccine and annual flu immunization are strongly recommended. 
  • All necessary vaccines are available at no charge at the health center. 
  • A declination form must be signed if the Hepatitis B or other recommended vaccine is declined.
  • Results of inquiry to Criminal Offender Record Investigation (CORI) must be acceptable under health center standards.

Lynn Community Health Center (LCHC) provides equal employment opportunities (EEO) to all employees and applicants for employment without regard to race, color, religion, sex, national origin, age, disability or genetics. In addition to federal law requirements, LCHC complies with applicable state and local laws governing nondiscrimination in employment in every location in which the company has facilities. This policy applies to all terms and conditions of employment, including recruiting, hiring, placement, promotion, termination, layoff, recall, and transfer, leaves of absence, compensation and training. LCHC expressly prohibits any form of workplace harassment based on race, color, religion, gender, sexual orientation, gender identity or expression, national origin, age, genetic information, disability, or veteran status. Improper interference with the ability of LCHC’s employees to perform their job duties may result in discipline up to and including discharge

Job Posting #20-047

Hours

Full-Time