Job Description
Job Description
Community Health Care Manager One (CHCM's) work with members enrolled in Medicaid to coordinate care and to connect them with essential community resources through partnerships with local physical and behavioral health providers. CHCM's aim to enhance individual health outcomes and the overall healthcare experience by identifying each person's health and wellness goals and improving their ability to navigate the healthcare system while also working to reduce high healthcare utilization costs. The CHCM One is position provides opportunity to learn care management and gain knowledge for future growth opportunity. Community Health Care Manager One report to the Community Health Care Management Supervisor.
Knowledge / Skills / Abilities
· Skills to communicate and interact appropriately and respectfully across multi-cultural differences.
· Strong critical thinking and problem solving abilities.
· Strong verbal communication skills (both over the phone and in-person).
· Basic Business writing skills.
· Strong customer service skills.
· Ability to multi-task, prioritize, and ability to handle multiple priorities while meeting deadlines.
· Computer skills including Microsoft Office (Outlook/Excel/Word), state administered data collection. systems, and other programs as needed or requested.
· Experience working with EMRs preferred.
· Experience partnering with local and regional health and human service resources preferred (not required).
· Experience working with Medicaid and Medicare preferred (not required).
· Ability to effectively engage and build rapport in a variety of medical, behavioral health, justice involved, substance use, and homeless situations.
· Strict Confidentiality required.
· Bilingual preferred (not required).
· Reliable transportation and a valid driver license and insurance
Education or Formal Training
· HS Graduate or GED required
Licensure/Certifications
· Valid Colorado Driver License and Insurance required.
Work Environment Physical Requirements
· Annual Influenza vaccination required for all employees
· Frequent contact with the public by phone and in person
· Sitting for periods of time while utilizing a PC or laptop
· Standing for periods of time on uneven ground at times
· Walking for periods of time on uneven ground at times
· Climbing up and down stairs
· Bending and reaching
· Lifting up to 30 pounds
· May be exposed to weather elements such as heat, rain, snow, etc. during member engagements.
· Work in confined spaces within proximity to other staff, noise, and discussions
Job Responsibilities/Essential Functions:
· Intake of incoming referrals and provide direct contact within 48 hours of receipt.
· Enter all documentation, contacts, and assessments into multiple databases with a high level of accuracy and timeliness.
· Work closely with supervisors on "campaign" and care plan assignments.
· Monitor members according to guidelines set by NCHA Policy and Procedure under the Care Management guidelines.
· Perform needs assessments and identify risk factors to develop person centered care plans.
· Conduct brief screenings and needs assessments to develop care plans and determine care management levels.
· Provide short-term monitoring, support, and education to promote self-management and preventive care (e.g., well child visits, immunizations, dental, and adult screenings).
· Assist members in understanding and accessing services, benefits, and community resources to address gaps in care.
· Manage and document member contacts using assignment tools.
· Identify and refer members requiring higher levels of care management.
· Track outcomes and report data to support performance improvement and KPI goals (e.g., preventive care, ED reduction).
· Review appropriate cost-effective care and decrease duplication of services for members.
· Understand, communicate, and facilitate member's complaints, grievances, and appeal processes.
· Regular case reviews with supervisor.
· Strict confidentiality of member records and communications following HIPAA Law.
· Expected to develop personal competencies through ongoing education and professional development.
· Focus on meeting individuals "where they are at" in their health journey.
· Educate members on how to navigate the healthcare system.
· Able to work independently and within a team-oriented office environment that may contain interruptions to work due to walk-ins, member needs, supervisor requests, phone conversations, etc.
· Able to manage stressful situations while remaining calm and non-reactive (i.e. working with members who may have severe and persistent mental health issues or substance use disorders)
· Able to utilize positive problem solving in difficult situations.
Other Duties as Assigned:
· Provide assistance as designated by Care Management leadership to support the overall goals and operational needs of NCHA, (such as on-the-job shadowing, staff relief, or other needs).
· Provide input into development of procedures and be accountable for adhering to them.
· Adhere to all programs designed to ensure due diligence in preventing, identifying, and reporting any unlawful or unethical behavior by colleagues, professional partners, or agents.
· Participation in ongoing performance improvement activities
· Provide oversight to students or guests wanting to learn about care management.
· Other duties as needed to meet demands of the organization (may include flexing or changing job location).
The above job definition information has been designed to indicate the general nature and level of work performed by employees within this classification. It is not designed to contain or be interpreted as a comprehensive inventory of all duties, responsibilities, and qualifications required of employees assigned to this job. Job duties and responsibilities are subject to change based on changing business needs and conditions.
The North Colorado Health Alliance was incorporated as a 501(c)(3) non-profit organization in 2002. The Alliance, based in the town of Evans in Colorado's Weld County, is a creative and strategic collaboration of partner organizations that are dedicated to cultivating the health of the communities they serve.
At the Alliance, we recognize that health does not begin or end with medical, dental, and behavioral health services. Health also depends on features of the built environment and on a variety of social determinants that make it harder for many to resist the chronic illnesses of our times. Thinking globally, the Alliance acts locally and creatively to convene, integrate, and support community partners in our common effort to make northeastern Colorado the healthiest region in the healthiest state.
Company Description
The North Colorado Health Alliance convenes partners and co-workers in education, community service, health care, business, faith-based organizations, and government. The Alliance's mission is to see Northern Colorado become the healthiest region in the healthiest state by developing and supporting a healthy population with 100% access to quality service and care at a sustainable cost.
Company Description
The North Colorado Health Alliance convenes partners and co-workers in education, community service, health care, business, faith-based organizations, and government. The Alliance's mission is to see Northern Colorado become the healthiest region in the healthiest state by developing and supporting a healthy population with 100% access to quality service and care at a sustainable cost.
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