Job Description

The Case Manager / Care Integration Manager manages and tracks all members who require a comprehensive approach to immediate and ongoing care of their complicated and / or catastrophic illnesses.  This positions also coordinates care for members experiencing a care transition from one level of care back to their residence.  The Care Integration Manager documents interactions with and on behalf of the member throughout service delivery including, but not limited to: care plans, progress notes, assessments, correspondence, and authorizations.

 

·         Act as a liaison to facilities, providers and/or members related to issues in case management, disease management and care services

·         Identify member needs and address these needs to remove any barriers in achieving optimal behavioral health and medical care

·         Educate members on the importance of good health and following up with the Primary Care Physician on a regular basis

·         Complete member surveys, assessments and individualized care plans

·         Assist member in creating member/caregiver goals, prioritizing goals, and creating a plan for self-management

·         Follow schedule/communication expectations

·         Request and review medical records

·         Provide and coordinate community resources and referrals

·         Provide member education on disease processes

·         Collaborate with the Interdisciplinary Team to incorporate best practices, assess outcomes and develop individualized care plans

·         Develop and monitor the member’s care plan goals for progress and outcomes

·         Accurately document members’ case management plans, authorizations, assessment, and levels of care

·         Manage a caseload of up to 150 members

·         Attend case management team meetings, as scheduled

·         Other duties as assigned by manager

Health Choice exists to improve the health and well-being of the individuals we serve through our health plans, integrated delivery systems and managed care solutions. We strive to recruit and retain only the finest health care professionals with the highest levels of integrity, compassion and competency. If you are driven by your own personal commitment to these values and desire to work in a team-focused, collaborative and supportive environment - while still being valued for your individual strengths - Health Choice is the place for you.

Equal Opportunity Employer Minorities/Women/Veterans/Disabled

 

~ksl

 



Qualifications

Minimum Requirements:

Associates degree or Bachelors degree from an accredited nursing school

Active, current, valid and unrestricted Utah state RN license

 

Preferred Qualifications:

At least two (2) years in a health care setting

HMO / Managed Care / Medicare / Medicaid experience

Broad knowledge of area community resources / agencies

Application Instructions

Please click on the link below to apply for this position. A new window will open and direct you to apply at our corporate careers page. We look forward to hearing from you!

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