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Care Manager I

Company: Colorado Access
Location: Aurora
Posted on: October 12, 2019

Job Description:

Under the supervision of theSupervisor of Care Management, theCare Manager I is responsible for completing the appropriate level care management activities for Colorado Access members. Care management activities will include but will not be limited to completing assessments, determining eligibility, monitoring provider services, coordinating services, developing care plans, delivering care management interventions, appropriate follow up activities and completing all documentation in the expected time frame. The Care Manager I will apply appropriate criteria, guidelines, regulations specific to the level of care and services required to meet the member/family goals and the organizational/contractual requirements. Care management functions may be performed for members in a variety of settings including telephonic, in-person or in the community setting.
The following essential functions of this position are performed personally, in cooperation with your supervisor, and/or in coordination with other staff. Additional work functions and duties may be assigned.

  • Completes mandatory and needs based health assessments to identify member strengths, needs, concerns and preferences through interviewing, observing, and utilization of standardized tools.
  • Establishes person centered goals and a plan of care with the client and their natural supports/family members.
  • Provides care coordination services and interventions by referring, educating, negotiating, and mediating with the member and external providers of member services.
  • Educates members regarding various state plan benefits, programs, options and services.
  • Monitors member status and satisfaction with services and makes adjustments to care plan as needed.
  • Monitors the ongoing provision of and need for care by assessing the delivery and quality of services and interventions provided by external providers.
  • Establishes professional and effective collaboration, communication, and coordination among all responsible parties of an individual member's interdisciplinary health care team.
  • As needed, attends member focused meetings (internal/external) to facilitate changes in services or collaborate in care.
  • Maintains knowledge of regulations, policies, and procedures regarding current public assistance programs.
  • Assists members and providers in understanding the complaint, grievance and appeal process.
  • Responsible for accurate and timely completion of all forms, reports, and documentation of care management activities.
  • Maintains professional and ethical manner with all interactions and meets performance, quality, customer service, and coordination standards as assigned by the department management team.
  • Participates in training and staff development opportunities. Actively participates in team meetings and communicates progress and barriers with Coordinator Supervisor and/or Department Manager.

    RequirementsEducation: Bachelor's degree in human behavioral sciences field.

    Experience: Prior care management experience preferred.

    Knowledge, Skills, and Abilities: Ability to process high volume of work efficiently with a high level of customer service detail. Knowledge of and ability to relate to populations served by the programs for which we work, client interviewing and assessment skills, knowledge of policies and procedures regarding public assistance programs, ability to develop care plans and service agreements, knowledge of resources, and negotiation, intervention, and interpersonal communication skills. Demonstrates support for the company's mission, vision and values. Position requires excellent written and verbal communication skills, strong organizational and time management skills, strong interpersonal skills and the ability to handle multiple priorities. Ability to work independently outside of office setting and conducting face to face assessment visits. Must have general computer skills and ability to work with Microsoft Office products. Requires the ability to use the complaint, grievance and appeals process and procedures to facilitate quality outcomes and/or resolutions for members. May be required to manage multiple priorities and projects with tight deadlines.

    Licenses/Certifications: A valid driver's license and proof of current auto insurance will be required for any position requiring driving.

Keywords: Colorado Access, Aurora , Care Manager I, Executive , Aurora, Colorado

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