Case Manager for Care Management

• Coordinates care which will include home visits that is safe, timely, effective, efficient, equitable, and client/member centered.
• Handles case assignments, drafts community-based carepath plans (including both informal and paid care) and reviews member progress toward carepath goals.
• Advocates for informed decisions by members regarding their status and treatment.
• Develop effective working relationships and cooperates with multiple teams throughout the case management process; may include primary care providers, managed care plans, home and community-based service providers (HCBS), informal caregivers etc.
• Communicates effectively with all members of the team, including formal and informal caregivers.
• Records and documents case information completely and accurately in accordance with Care Management Services guidelines.
• Collaborate with internal team members, including Program Support Specialists for Care Management Services, to ensure communication for continuity of care for cases assigned.
• Identifies and resolves carepath variances as they occur; consults with internal and external teams as indicated to ensure effectiveness of community carepath.
• Refers members to a wide variety of community resources as indicated, for formal and informal assistance.
• Works to preserve the essential role of family and informal caregivers in assisting members in meeting carepath goals and addressing social risks.
• Promotes quality and cost-effective interventions and outcomes.
• Assesses and addresses member motivational and behavioral barriers to optimal health and function.
• Assists in removing barriers to primary and specialized medical care, to support optimal health and functional status.
• Meets all mandated reporting requirements.
• Takes call on a rotating basis as assigned.

• Maintains and monitors quality through effective collaboration with Quality Assurance and Education Coordinator for Care Management Services and Administrator for Care Management Services.
• Ensures effective implementation of Quality Assurance and Education plans, initiatives and processes.

• Maintains prompt, accurate and secure documentation as it relates to member needs, contacts and plans.
• Ensures appropriate documentation is filed promptly in members’ chart as outlined in operational Care Management Services Guidelines.
• Ensures member information is secure when removed from the assigned location.

• Accurately reports work time and business expenses in accordance with organizational guidelines.
• Provides on-site assistance for all state surveys, unless previously excused by Administrator for Care Management Services.
• Reports corporate compliance concerns appropriately.

• Participates in weekly multidisciplinary team meetings prepared to discuss assigned members and to present new members.
• Participates in weekly staff meetings.
• Participates in all meetings and in-services as required.
• If a Licensed Practical Nurse or Registered Nurse, may be required to perform Assessment Nurse LPN duties as needed.
• Assists with Case Manager duties for other locations as needed.
• Promotes the image and reputation of the System by exhibiting servant leadership and providing direct and open lines of communication.
• Contributes to the work of committees, workgroups, project management, and other collaborative efforts of the System.
• Performs other duties as necessary to ensure the success of the System.

• Thorough knowledge of, adheres to current regulations, Personnel and Operational Guidelines and best practices related to the operations of the Elderly and Disabled Waiver Program and the organization.
• Performs all duties of the Case Manager as outlined in state and program regulations, as well as operational guidelines.
• Demonstrated listening skills, to understand what client’s has needs and develop a plan that will address the needs.
• Compassion, especially dealing with difficult family or complex social issues.
• Completes work in a timely, accurate, and efficient manner.

• Exceptional organization and planning skills as well as the ability prioritize assignments/responsibilities.
• Cultural awareness and competence, to understand and value client’s unique perspectives.
• Maintains constructive working relationships with all member of the interdisciplinary team by communicating and interacting effectively with supervisors, organizational leadership, peers and individuals inside and outside the System, in a positive, professional and respectful manner.
• Portrays a positive image of the organization and communicates guiding principles, mission, vision and values.
• Excellent knowledge of case management principles.
• Consistently reports to work on time prepared to perform duties of the position.

• Ability to work a demanding, primarily self-directed work schedule.
• Demonstrates good judgment and decision-making.
• Ability to deliver excellent customer service, externally and internally as well as maintain customer confidentiality.
• Ability to react effectively and calmly in emergency situations.

• Bachelor’s degree in Social Work or related human services field is required with 2 years of experience
• Or Valid Georgia LPN license with 2 years of experience
• Experience in social work, home and community based services, healthcare or geriatrics preferred.
• Valid Driver’s License.
• Reliable Transportation.

CHSGa