Job Description

TITLE: MLTC Care Manager  (Bilingual Spanish)

HOURS: M-F 9-5  

SUMMARY:
HYBRID  OfficeHome/Field (1-2 days a week to perform the 6 month UAS reassessments). Caseload 180- 200. Telephonic care management for members, requires to work day(s) in the field providing assessments
(UAS tool is used to confirm members eligibility to receive medicaid benefits
TRAINING for this role is NOT HYBRID,  candidates are required to be available for 4-6 weeks in office, everyday - no exceptions made
there is an additional 2 weeks in the field in the area they will be working with the Preceptor for 2 weeks, no exceptions. (total 4 weeks of training)

Once trained and they start working, they are not looking for accommodation requests for what days they will be going in the field, and what days they will be working office vs home, they will provide them a schedule, no exceptions.

RESPONSIBILITIES:

Work From Home/Field /Office Hybrid: This role 2  days WFH, 1day in the field, 2 days in the office

The Nurse Care Manager will be responsible for providing telephonic care coordination AND in-home assessment (once a week), planning, facilitation, advocacy and authorization of covered plan services to meet the member’s health needs while promoting quality cost effective outcomes. 

Work with member/family to maintain the most independent living situation possible; ensure consistent care along the entire health care continuum by assessing and closely monitoring member’s needs and status. 

Authorizes covered services and coordinates care regardless of payer. 

Will collaborates and communicates with member/family/caregivers, primary care practitioners, and the interdisciplinary team., in the field they are performing reassessments for the patients.

Telephonic case management to members who need medical, social, psychological, physical and spiritual needs by developing, implementing and monitoring the member's care plan in conjunction with other team members in order to help meet the member's needs. This position works in conjunction with other IDT members in ensuring MLTC members are getting the best possible care needed.
Calls will be made to members or their families, to ensure they are receiving care  HHA are following care plans, or making recommendations if necessary, if the member needs additional services, and providing resources within the organization, and collaborating with physicians, and IDT(Interdisciplinary Team)

COVID: Not Required

MIN QUALIFICATION:

RN, BSN , longevity 2-3 years plus no jumpy. MLTC required. CAR & DL. Language Required (Chinese)

Job Tags

Work at office, 2 days per week, 1 day per week,

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