Manager overseeing reconciliation activities for Amazon transactions. Supervise team and ensure timely resolution of financial discrepancies in Gordonsville facility.
About the role
- Clinical Care Manager responsible for coordinating care for dually-eligible enrollees in MA. Engaging community resources and healthcare providers to improve health outcomes.
Responsibilities
- The Clinical Care Manager is responsible for providing monitoring, follow-up and clinical care management to dually-eligible enrollees with complex medical, behavioral and social care needs.
- Engage with the enrollee in their homes and other community settings to establish a complex care management relationship.
- Function as a liaison between healthcare providers, community resources, and enrollees.
- Perform required assessments on a timely basis, including Comprehensive Assessment, MDS-HC (or successor) Functional Assessments, and Crisis and Risk Assessments.
- Lead the interdisciplinary care team (ICT) to create holistic care plans.
- Oversee enrollee utilization of long-term services and supports.
- Assist members in accessing community resources like housing, food assistance, etc.
- Provide education to members and families about managing chronic conditions and preventive care.
- Follow up with members after hospitalizations to ensure continuity of care.
- Advocate for the needs and preferences of enrollees within the healthcare system.
Requirements
- Associates of Science (A.S.) degree in nursing from an accredited nursing program required or Master's degree in social work or mental health counseling and independent license required
- Three (3) years of experience as a Registered Nurse/BH Clinician or One (1) year as a Registered Nurse/BH Clinician with two (2) years of experience working with people with complex medical, behavioral and social needs as an LPN, CHW, MA required
- Prior experience in care coordination, case management, or working with dual-eligible populations preferred
- Medicaid and/or Medicare managed care experience preferred
- Intermediate proficiency level with Microsoft Office, including Outlook, Word and Excel.
- Understanding of Medicare and Medicaid programs, as well community resources and services available to dual-eligible beneficiaries.
- Must have valid driver's license, vehicle and verifiable insurance.
- Influenza vaccination is a requirement of this position.
Benefits
- Health insurance
- Retirement plans
- Flexible work arrangements
- Professional development opportunities
- Significant bonuses tied to individual and company performance
- Employee well-being programs
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