Purpose/belief statement: The position of Care Manager is part of Healthcare Services and reports to the Director of Care Coordination who reports to the VP of Healthcare Services and Quality Operations. This position will have strong working relationships with the Chief Medical Officer and other key contributors across the enterprise. The Care Manager will be responsible for coordinating member-care, developing actionable care plans, communicating effectively and ensuring high-quality healthcare services are delivered to members in an institutional setting within a special needs plan (ISNP). Job duties determining and educating on the choices available to the individual member. Establish a care plan that is mutually agreed upon by the interdisciplinary care team and the member/representative/family. Care plans will be established and maintained utilizing the SMART framework (Specific, Measurable, Achievable, Relevant and Time-bound) and communicated to all members of the interdisciplinary care team. Collaboration : Collaborates with the interdisciplinary team (ICT) which may include Medical Director, PCP, nurse practitioners/physician assistants, pharmacy, dietary, social workers, other clinical and non-clinical disciplines, facility staff, member representatives and family to establish, revise and continuously evaluate the member centric care plan and conduct documented interdisciplinary care team meetings to be able to work proactively rather than reactively. Care Manager will work closely with Utilization Management, Compliance and Quality to adhere to the Model of Care and ensure quality assurance, cost efficiency and member safety/satisfaction. Member Education : Provide education to members and their families about managing chronic conditions and promotion of self-management strategies. Documentation : Maintain accurate and timely documentation of member care activities and any interaction related to the member in compliance with healthcare regulations. Qualifications
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