Care Manager I
Company: Colorado Access
Posted on: October 12, 2019
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.
ESSENTIAL FUNCTIONS& WORK DUTIES
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
- 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
RequirementsEducation: Bachelor's degree in human behavioral
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
Keywords: Colorado Access, Aurora , Care Manager I, Executive , Aurora, Colorado
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