Clinical Care Manager - HireLevel. : Job Details

HireLevel is seeking a Clinical Care Manager that will develop, assess, and manage comprehensive care plans for members with primarily physical health needs. This role will provide outreach to members, complex case management.

This is Remote but must reside in Missouri.

Our client is a fortune 500 company who is a nationwide leader in the healthcare services field and they pride themselves on their ability to provide a wide range of government sponsored healthcare programs; including a variety of insurance solutions.

Job Category: Contract:

• Start Date: As soon as possible
• End Date: Possibility for extension

Hours: Monday – Friday | 8a – 5p

Compensation: $46.52/hr.

Key Responsibilities:

• Evaluate member needs by identifying barriers to accessing appropriate care, social determinants of health, and focusing on member-identified priorities to recommend and facilitate the best care outcomes.
• Develop and maintain care plans in collaboration with healthcare providers, identifying specialists and community resources to address unmet member needs.
• Provide care management interventions to address issues or barriers to care.
• Coordinate care between members, families/caregivers, and care provider teams to ensure person-centered care.
• Monitor and follow up with members to assess changes in condition and progress towards care plan goals, revising care plans as needed to meet evolving needs.
• Offer resource support for services such as employment, housing, independent living, and foster care based on member assessments and care plans.
• Facilitate access to care by collaborating with providers and specialists to ensure timely service delivery.
• Perform outreach via telephone, digital platforms, or in-person visits to assess member needs and collaborate on care plans.
• Document all member information and care management activities in compliance with state, federal, and payer regulations.
• Educate members and their families on disease management, healthcare options, care gaps, referrals, and healthcare benefits.
• Provide feedback to leadership on improving care delivery and member outcomes in a cost-effective manner.
• Other duties as assigned by leadership to meet business needs.

Education & Experience:

• Degree from an Accredited School of Nursing or Bachelor's degree in Nursing required.
• 2 years of experience in behavioral health management and/or acute behavioral health care setting focusing on outpatient/inpatient utilization, case management and discharge planning.
• 1+ year of experience in current case management as a licensed professional
• Must have experience working with the needs of vulnerable populations who have chronic or complex bio-psychosocial needs

License/Certification:

• Active RN License in State of Practice and/or Compact State Licensure required.
• License in Behavioral Health field (e.g. LCSW, LPC, Psychologist)

We are an equal opportunity employer.