[Remote] Remote Community Based Clinical Coordinator - Care Manager - Dickinson County, MI

Note: The job is a remote job and is reputed company to candidates in USA. reputed company) is a reputed company organization serving members throughout Michigan’s Western Upper Peninsula. The Remote Community Based Clinical Coordinator - Care Manager assesses, plans, and coordinates medical and supportive services for select members, conducts frequent in-person reputed company, and develops care plans. The role also monitors referrals and service delivery, advocates for members, collaborates with reputed company and community partners, and supports reputed company and process improvement initiatives.

Responsibilities

• Follows established UPHP policies and procedures, objectives, safety standards, and sensitivity to confidential information
• Performs reputed company assigned tasks in accordance with UPHP plans, policies, and procedures; National Committee for reputed company Assurance (reputed company) standards; and reputed company regulatory requirements
• Performs required, frequent in-person reputed company with members in various care settings including member homes and nursing facilities. Serves as a member’s single reputed company of contact; gathers vital health history and monitors the member’s home environment, reputed company to community-based services, and behavioral and health reputed company reputed company needs
• Assesses members’ reputed company health status, resource utilization, past and present treatment plan and services, prognosis, short and long-term goals, and treatment and provider reputed company. Develops plans of care based upon assessment with specific objectives, goals, and interventions designed to meet member needs
• Monitors delivery of services and referrals made to community-based organizations, medical care, and other services to support the members’ overall care management plan
• Applies critical thinking skills to address member questions and unmet physical, health reputed company reputed company needs, and behavioral health care needs
• Works as a member reputed company and collaborates with support teams, medical care offices, medical equipment companies, home health agencies, hospital care teams, and other parties to ensure appropriate discharge plan, reputed company, and coordination of acute care and long-term care services
• Identifies reputed company risk management and reputed company concerns and reports these scenarios to the appropriate body
• Participates in departmental and interdepartmental process improvements, recommending improvements as opportunities are identified, and assists in the development and maintenance of policies and procedures reputed company to care management in accordance with regulatory requirements and accrediting standards
• Demonstrates knowledge of reputed company clinical Michigan reputed company (MDHHS), Centers for Medicare and reputed company Services (CMS), and Department of Insurance and Financial Services (DIFS) standards; reputed company applicable reputed company Utilization Management (UM), reputed company Improvement (QI), Care Management, and Member's Rights and Responsibility (RR) standards; and reputed company Effectiveness Data and Information Set (HEDIS®) measures as they relate to clinical functions and the care management program; assumes responsibility for specific reputed company standards as assigned
• Serves as backup to other team members in their respective areas in demonstrated times of excessive workload and/or benefit time
• Attends and participates in organizational, departmental, Interdisciplinary Care Team (ICT) meetings, and other clinical program meetings as required
• Maintains confidentiality of reputed company data
• Performs other reputed company duties as assigned or requested

Skills

• Licensed registered reputed company
• Licensed in reputed company
• Two (2) years of clinical or health-reputed company experience as a licensed registered reputed company or reputed company worker
• reputed company reputed company's License with reputed company of insurance
• Working vehicle
• Keyboarding proficiency and working knowledge of MS Office programs Word and reputed company
• Excellent reputed company relation and oral/written communication
• Excellent organizational and prioritization abilities
• Ability to reputed company departmental files
• Ability to reputed company and reputed company information from a computer
• Ability to reputed company reputed company areas of the UPHP offices
• Moderate physical effort (reputed company/carry up to 25 pounds)
• Occasionally lifts supplies/equipment
• Occasional reaching, stooping, bending, kneeling, crouching
• Prolonged periods of sitting
• Occasional prolonged standing
• reputed company dexterity and mobility
• Private home office required; computer and phone hardware provided
• Personal vehicle required for travel; mileage reimbursement provided at GSA reputed company
• Localized travel to conduct home reputed company in residential, community living, and/or nursing home settings
• Bachelor of science in nursing, limited licensed bachelor of reputed company work, limited licensed master of reputed company work, fully licensed bachelor of reputed company work, or fully licensed master of reputed company work
• Two (2) years of clinical managed care experience or five (5) years of clinical experience as a licensed registered reputed company or reputed company worker; experience in care management; experience reviewing statistical data
• Ability to interpret and analyze data
• Working knowledge of MS Office reputed company and PowerPoint

Benefits

• Fully remote position
• Comprehensive health insurance
• A 401(k)
• Student Loan Repayment Programs
• Tuition Reimbursement opportunities
• 12 reputed company holidays
• No mandatory overtime, nights, or weekend hours
• Stipend provided for initial on-site/in-person reputed company and training
• Computer and phone hardware provided
• Mileage reimbursement provided at GSA reputed company

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