Social Worker Job In Kapolei, Hawaii
CASE MANAGERNext Steps... Apply Now
Case Manager is responsible for triaging, assessing, and managing of members referred to Case Management
We are currently seeking a dynamic CASE MANAGER to join our team at our office in Kapolei. The Case Manager is responsible for triaging, assessing, and managing of members referred to Case Management. Responsible for the tracking and managing of members identified as needing Case Management who may be high risk, high utilizing, at significant clinical risk or under-utilizing services. The Case Manager is responsible for providing outreach, case management, education and support to HMSA member by performing clinically based activities to coordinate care between the members, providers and community resources.
- Identification and tracking of all assigned CM Members
- Conducts independent assessment and re-assessment of members enrolled in CM in compliance with program standards
- Development of a comprehensive care plan to address areas or risk and/or need as identified via the assessment; updates the care plan as clinically indicated
- Maintains on-going contact with the member/ guardian
- Provides continuum of quality care through mainly telephonic outreach, education, crisis intervention and other clinically based activities to plan members as specified in their treatment plans.
- Collaborates and coordinates with member's medical/health and community based providers (including the PCP, medical professionals, behavioral health specialists, or others as needed) regarding the member's treatment/discharge needs and plan of care.
- Collects clinical data and maintains accurate records of activities information into database for tracking and metrics purposes.
- Collaborates with the care management team to review care management process for members to ensure needs of members are met.
- Occasional, in person outreach and engagement of members
- Assist with NCQA and URAC initiatives, including but not limited to ensuring compliance with NCQA MBHO QI9
- Provide Service Coordinator to HMSA QUEST members with a behavioral health special health care need as needed.
: Staff providing Case Management services will have at least one of the following:
- Master's degree or higher in a health related field and licensure as a behavioral health professional (LSW or LCSW)
- RN licensure as a professional and 3 years of behavioral health clinical experience.
: Must have current, valid and unrestricted Hawaii licensure with proof upon date of hire. Re-verification will take place no less than every 3 years.
Knowledge, Skills & Abilities:
- 3 plus years of Case Management experience
- Educated in current principles, procedures and knowledge domains of case management based on nationally recognized standards of case management
- Ability to prioritize and manage multiple projects and assignments.
- Knowledge of client's rights, state and federal laws, and regulations, such as those relating to health services, confidentiality, and consent issues for the targeted population.
- Knowledge of HIPAA and other privacy regulations
- Ability to work independently, handle multiple assignments and prioritize workload.
- Ability to seek help in managing workload, when appropriate.
- Requires safely operating an insured automobile for travel to off-site locations to conduct and accomplish business related activities. Must have current and valid driver's license, access to an automobile with current registration and no fault insurance.
- Able to travel to off-site meetings with members, providers and community agencies. Must be able to transport self and equipment to community sites, member homes, physician offices etc. May require ability to travel to Neighbor Islands and flexibility in being available to work after hours and on weekends when needed.
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Beacon Health Strategies, LLC., a Beacon Health Options company, is proud to be an Equal Opportunity Employer as well as a Drug Free Work Environment. EOE/M/F/Veterans/Disabled
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