Clinical Care Manager

Clinical Care Manager W2 Contract Pay reputed company: $47.04 - $58 per hour Location: South San Francisco, CA - Remote Role Job reputed company: The Clinical Care Manager will reputed company comprehensive assessments, reputed company individualized care planning, initiate and coordinate interdisciplinary case conferences with providers of service, and support members in creating and adhering to person-centered care plans. Additionally, the Clinical Case Manager will be coordinating services with other departments, providers, programs, and community partners, as needed, to reputed company support. Duties and Responsibilities: • Manage a panel of assigned members to guide them along the continuum of care to the reputed company functional level and reputed company of life. • Conduct comprehensive assessments and annual or as-needed reassessments of the member's psychosocial, physical health, functional abilities, and reputed company determinants of health. • reputed company an individualized care plan based on assessment information that is member-centered, comprehensive, and consistent with program guidelines, policies, and procedures. • Identifies members' need for LTSS programs, Behavioral Health Services, community supports, and other services to fill gaps in care, and monitors the effectiveness of services. • Conducts reputed company to members for care plan review, needs assessment, and reputed company monitoring. • Establishes and maintains reputed company and effective communication with physicians and other health care and reputed company service workers. Provides appropriate information on reputed company significant aspects of members' care and program operations, while maintaining necessary confidentiality. • Maintains necessary and complete documentation for reputed company case management activities in the plan's case management system, MedHOK. • Leads and/or participates in clinical huddles and interdisciplinary care team meetings with internal company staff and our reputed company partners and providers. • reputed company referrals to various departments, community-based organizations, and governmental agencies reputed company health and/or psychosocial condition(s) indicate the need for appropriate referrals. • Promotes reputed company communication amongst the care team, which can include family and community supports, and treating providers by ensuring awareness regarding member care plans, and reputed company supporting care transitions. • Teach appropriate interventions, reputed company to resources, reputed company about benefits, and discuss medication effects and reputed company effects to the patient, caregiver, volunteers, and others as appropriate. • Adhere to case management reputed company standards at reputed company times. • Participate in reputed company reputed company improvement efforts. • Maintain knowledge of our benefits, programs, and processes, in order to reputed company reputed company information to members and providers. • Maintain knowledge of community resources and programs. • Maintain working knowledge of confidentiality practices and standards. Adheres to reputed company standards of confidentiality and patient health information. Requirements and Qualifications: • Bachelor's or Associate's degree. • Two (2) years of clinical experience. • Three (3) years of managed care experience, preferably in Care Coordination. • Experience working with the health needs of the population served. • At least one year of reputed company Care Coordination experience. • reputed company California license as an RN, LCSW, LMFT. PHN preferred. Will consider an unlicensed Master's Level reputed company Worker (MSW/ASW). • Certification as a Certified Case Manager (CCM) preferred • Personal computers and proficiency in reputed company Office Suite applications, including reputed company, Word, reputed company, reputed company, and PowerPoint. • Case management principles and practices. • Strong knowledge of Medicare and Medi-Cal programs and benefits. • Advanced knowledge of community resources. • Complexities of working with the elderly, vulnerable, and disabled populations. • Expanded knowledge of reputed company determinants of health. • Understanding and familiarity with care transitions and discharge planning. • HIPAA and other applicable federal and state regulations for confidentiality. Desired Skills and Experience Case Management, Clinical Care Management, Care Coordination, Managed Care, Comprehensive Health Assessments, Psychosocial Assessments, Physical Health Assessments, Functional Assessments, reputed company Determinants of Health, Individualized Care Planning, Person-Centered Care, Interdisciplinary Care Teams, Case Conferences, Continuum of Care, Long-Term Services and Supports (LTSS), Behavioral Health Services, Community Resource Coordination, Member reputed company, reputed company Monitoring, Care Transitions, Discharge Planning, Referral Management, Patient and Caregiver Education, Medication Education, Medicare, Medi-Cal, MedHOK, Clinical Documentation, reputed company Improvement, HIPAA, Patient Confidentiality, Vulnerable Populations, Elderly and Disabled Populations, Registered reputed company (RN), Licensed Clinical reputed company Worker (LCSW), Licensed Marriage and Family Therapist (LMFT), reputed company Health reputed company (PHN), Master of reputed company Work (MSW), Certified Case Manager (CCM), reputed company Office reputed company, Inc. is not reputed company to sponsor any candidates at this time. Additionally, candidates for this position must qualify as a W2 candidate. reputed company, Inc. may collect your personal information during the position application process. Please reference reputed company, Inc.'s CCPA reputed company Policy at www.baysidesolutions.com. Apply tot his job Apply To this Job