Care Manager, Care Manager Job Description

Care Manager, Care Manager Job Description

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167 votes for Care Manager, Care Manager
Care manager, care manager provides information to members and providers regarding mental health and autism benefits, community treatment resources, mental health managed care programs, and company policies and procedures, and criteria.

Care Manager, Care Manager Duties & Responsibilities

To write an effective care manager, care manager job description, begin by listing detailed duties, responsibilities and expectations. We have included care manager, care manager job description templates that you can modify and use.

Sample responsibilities for this position include:

Assess the appropriateness and economy of an admission to a health care facility or a continued hospitalization
Monitor the length of the hospital stay compared to the average length of stay for similar diagnoses
Discharge patients without compromising the quality of outcomes
Patient and benefit monitoring
Visit patients in the home
Review charts
Operating improvements and quality performance through productivity
Identify and recruit populations
Coordinate and oversee services between patient and extended care team providers
Conduct case finding and engagement of new referrals

Care Manager, Care Manager Qualifications

Qualifications for a job description may include education, certification, and experience.

Licensing or Certifications for Care Manager, Care Manager

List any licenses or certifications required by the position: CPR, CCM, CMS, CCP

Education for Care Manager, Care Manager

Typically a job would require a certain level of education.

Employers hiring for the care manager, care manager job most commonly would prefer for their future employee to have a relevant degree such as Bachelor's and Master's Degree in Nursing, Health, Education, Health Care, Substance Abuse, Social Work, Healthcare, Social Sciences, Human Services, Management

Skills for Care Manager, Care Manager

Desired skills for care manager, care manager include:

Relevant product line
InterQual and LOCADTR
Most current diagnostic edition
DSM V
Utilization management procedures
Mental health and substance abuse community resources and providers
Internal and external resources to meet patient needs
5.5
Community resources
Treatment care resources and levels of care available

Desired experience for care manager, care manager includes:

Maintain client-related records and other required documentation
Accompany patients to appointments
Provide direct care management services to clients living with HIV/AIDS, other chronic diseases, substance abuse, and/or mental illness
Conduct data entry to program-related portal
Maintain client-related records and other required documentation according to the protocols and standards of the agency's support services department
Represent the agency at various venues to promote agency services

Care Manager, Care Manager Examples

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Care Manager, Care Manager Job Description

Job Description Example
Our company is growing rapidly and is looking to fill the role of care manager, care manager. To join our growing team, please review the list of responsibilities and qualifications.
Responsibilities for care manager, care manager
  • Maintains confidentiality, ethical and professional standards, adhering to ValueOptions Clinical Policy and Procedures and Benefit Plan requirements
  • Attend educational workshops
  • Assist members and their families in the administration of their health plan benefits, promote medication compliance, align with healthcare professionals, assist in shared decision-making
  • Coordinates with other Care Managers within Beacon within other facilities/agencies to ensure that patient comprehensive treatment needs are met
  • Implement all care management reviews according to accepted and established criteria, other approved guidelines and medical policies
  • Maintain caseload size established by the department and meet monthly core service productivity requirements
  • Conduct hospital discharge calls within 24 business hours of discharge to confirm outpatient FHC appointments, to schedule/re-schedule appointments when necessary, and to address barriers to appointment compliance
  • Conduct Pt pre-visit planning for high risk patients and communicate patient health status alerts to the patients care team
  • Advocates for patients when barriers to care exist including language and literacy barriers, access to transportation, problems with insurance coverage, child care problems, appointment scheduling conflict, etc
  • Assist patients in creation and implementation of care plan goals including lifestyle behavior change goals to improve health outcomes
Qualifications for care manager, care manager
  • Master’s Degree or higher or RN
  • Minimum of three (3) years of clinical experience in a behavioral health setting/ managed care experience
  • Current, valid and unrestricted independent licensure for practice required with proof on date of hire
  • Strong customer service orientation and excellent written and verbal communication skills
  • Care Managers are required to be educated in current principles, procedures and knowledge domains of case management based on nationally recognized standards of case management and must be a licensed behavioral health clinician or RN
  • Knowledge and experience working with behavioral risk groups, including Injection Drug Users, Lesbian, Gay, Bi-sexual, and Transgendered Community
2

Care Manager, Care Manager Job Description

Job Description Example
Our company is looking to fill the role of care manager, care manager. If you are looking for an exciting place to work, please take a look at the list of qualifications below.
Responsibilities for care manager, care manager
  • Serve as a point person in the office for telephone calls, general emails, and walk-in students
  • Provide data on important assessment needs, trends, and contacts
  • Facilitates coordination of a multidisciplinary plan of care to guide patient progress to promote the achievement of optimal clinical, quality, and cost effective outcome
  • Coordinates with other Care Managers to assure that members’ comprehensive treatment needs are met
  • Refers cases that do not meet criteria and need non-authorization decision to Peer Advisor
  • Utilizes rounds and case consultations to Clinical Supervisor and Peer Advisor for quality of care cases
  • Ensures continuity of patient care through contact with providers and assigned individuals
  • Clinical documentation to reflect recovery principles, active and longitudinal care management interventions and quality of care issues
  • Completes monthly referral registrations to meet quantitative and qualitative standards
  • Conduct hospital discharge calls for patients on caseload within 24 business hours of discharge to confirm outpatient FHC appointments, to schedule/re-schedule appointments when necessary, and to address barriers to appointment compliance
Qualifications for care manager, care manager
  • Two (2) years of post graduate practice in a health care setting preferred
  • Licensed Master's Social Worker or
  • Clinical Social Work Associate or
  • Registration within one (1) year of hire into the position required
  • Employee may not call her/himself a Social Worker until licensure/registration is obtained
  • Computer, telephone, fax machine, and photocopy machine skills required
3

Care Manager, Care Manager Job Description

Job Description Example
Our innovative and growing company is hiring for a care manager, care manager. If you are looking for an exciting place to work, please take a look at the list of qualifications below.
Responsibilities for care manager, care manager
  • Manages a caseload of assigned patients of which a proportion, 30 to 60 patients are actively followed by the complex care manager
  • Assesses over time the health care, educational, and psychosocial needs of the patient/family
  • Provide client advocacy and referral and liaison activities to address social determinants of health
  • Provide appropriate frequency and type of billable encounters, as directed by Supervisor
  • Support timely completion of High/Medium/Low assessments ensuring the appropriate acuity of the members is documented
  • Document all encounters timely and appropriately in assigned technology platform(s)
  • Initiate a member’s care plan identifying mutual goals, interventions and timeframes
  • Keep care plan current and ensures progression towards goals
  • Identify barriers and engages supervisor and care team
  • Work exclusively with a caseload of clients who are enrolled in Health and Recovery Plans
Qualifications for care manager, care manager
  • Current Washington State license as a Registered Nurse required
  • For incumbents hired prior to December 1, 2014, an LPN license plus five years of additional experience is acceptable
  • Three years acute care experience required
  • Face to face assessment preferably within one (1) business day of arrival, and no later than (2) business days
  • Advocates for continued authorization of post-acute services
  • Obtains authorizations for medications which require prior-authorization
4

Care Manager, Care Manager Job Description

Job Description Example
Our innovative and growing company is looking for a care manager, care manager. If you are looking for an exciting place to work, please take a look at the list of qualifications below.
Responsibilities for care manager, care manager
  • Record utilization management decisions in FlexCare and /or Health Plan Electronic systems according Beacon Standard Operating Procedures
  • Provides coaching and education to members, and their families, related to health care conditions including medication, treatment adherence, appropriate use of emergency room, and navigation of the health care system
  • Participate in clinical rounds to promote integrated case discussions and solution-focused outcomes
  • Attends all mandatory company or department meetings
  • Reports to each scheduled shift and commences work and perform essential job function at the start of each scheduled shift
  • Completes comprehensive assessment of the medical, behavioral health and psychosocial needs of identified members, in order to establish, and implement, culturally competent care management plans to address identified needs
  • Completes face-to-face visits with members and their families within inpatient settings and/or their homes, as needed
  • Creates patient-centered and culturally competent Individualized Care Plan (ICP) to include problem identification, goal setting, interventions and expected outcomes
  • Provides health coaching and education to members related to health care conditions and treatment plans with a focus on medication and treatment adherence, appropriate use of emergency room, and navigation of the health care system
  • Participates in clinical rounds to promote integrated case discussions and solution-focused outcomes
Qualifications for care manager, care manager
  • 3 years experience coordinating referrals and intake services with patients with at-risk populations who also struggle with substance use/addiction, mental health, and complex chronic health conditions
  • Graduate of an accredited School of Nursing, Minimum Required
  • Bachelors Degree of Science in Nursing, Required for Care Manager
  • 2-3 years acute care hospital setting, Minimum Required
  • Strong verbal and written communication and facilitation skills, Minimum Required
  • Strong assessment skills, time management skills, critical thinking skills, Minimum Required
5

Care Manager, Care Manager Job Description

Job Description Example
Our company is growing rapidly and is looking for a care manager, care manager. Please review the list of responsibilities and qualifications. While this is our ideal list, we will consider candidates that do not necessarily have all of the qualifications, but have sufficient experience and talent.
Responsibilities for care manager, care manager
  • Attend case conferences, internally and with the client, to present claims recommendations
  • Review decision recommendations made by Case Managers on tax qualified policies
  • Meet quality and production metrics established and communicated by the department
  • Maintain clinical license in good standing
  • Complete comprehensive assessment of the medical, behavioral health and psychosocial needs of identified members and their families when delegated by the Health plan through the (HRA) process, enrollment and trigger reports, and other case identification sources, and establishingand implementing culturally competent care management plans to meet the needs of members
  • Participate in rounds forums to promote integrated case discussions and problem-solving
  • Minimum of 6 years post-degree experience in psychiatric and substance abuse health care
  • Minimum of 3 years post degree experience for Care Managers with Ph.D
  • Knowledge and experience in inpatient setting
  • Provides guidance to client organizations regarding behavioral problems in the workplace
Qualifications for care manager, care manager
  • Ability to interact with clients, faculty, & staff at all levels
  • Ability to deliver clinical care services in an efficient and effective manner
  • Well-developed communication skills, both spoken & written
  • Computer literate, including MS Office applications
  • Required Illinois's HIV/AIDS specialty program requires either a Bachelor's degree or 4+ years Case management experience and experience in addictive & dysfunctional family systems, racial & ethnic minorities, homosexuals, persons with AIDS and substance abusers
  • Required Illinois's Children with High Needs program requires a bachelor's degree in nursing, social sciences, social work or related field

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