Community Health Plan of Washington · 4 months ago
Regional Field Case Manager I - North Sound
Seattle, Washington, United States
Full-time
Hybrid
Mid Level
3+ years expCommunity Health Plan of Washington is an equal opportunity employer committed to a diverse and inclusive workforce. The Regional Field Case Manager I is responsible for the plan’s regional field care management and coordination programs, providing care management services for members with various medical and behavioral conditions while advocating and coordinating resources in the community.
Health Care
Responsibilities
Engages with members, providers and agencies in the assigned region to support field care management services
Provides face-to-face visits to members where telephonic care management is a barrier, to foster effective participation in the care management program
Identify and partner with emergency response services or other programs in a community that support members who are high utilizers of medical/behavioral health services. Field case management can include meeting members in acute care, emergency room, adult family home, Inpatient behavioral health facilities, shelters, community health centers, members home or member preferred location
Assesses, evaluates, plans, implements, and documents the care of members within the organizations’ clinical database system in accordance with organizational policies and procedures
Implements the plan of care through direct member care, coordination, and delegation of the activities of the health care team. Promotes continuity of care by accurately and completely communicating to health care team the status of members for whom care is provided
Evaluates members’ progress towards goals, identify potential barriers, assists members in navigating the healthcare system and expected outcomes in collaboration with member and the interdisciplinary care team
Works within the multi-interdisciplinary care team that collaborates with providers, members, caregivers, contracted vendors, community resources, and health plan partners to assess the member's health status, identify care needs and ensure access to appropriate services to achieve positive health outcomes
Advocates on behalf of members and facilitates coordination of resources required to help members reach optimum functional levels and autonomy within the constraints of their disease conditions
Represents CHPW Care Management Department in the community to provide education on care management programs and collaborate with providers and community partners. Leads regional based projects as assigned
Participates in external care conferences and other d/c planning activities that may be needed to prevent a readmission as needed
Participates in clinical case review with internal interdisciplinary team at Care Management Rounds
Employees are expected to report to work as scheduled, participate in all assigned meetings, and meet established performance and accountability standards
Other duties as assigned. Essential functions listed are not necessarily exhaustive and may be revised by the employer, at its sole discretion
This position requires traveling on behalf of the Company and working in the field at least 50% of the time. It is essential that a current driver’s license, proof of insurance and an acceptable driving record are maintained
Qualification
Required
Possess a Bachelor's degree in nursing or a master's degree in social work and/or a related behavior health field (required)
Have a current, unrestricted license in the state of Washington as a registered nurse (RN) (required) OR
Have a current, unrestricted license in the State of Washington as a Social Worker (LSWAA, LSWAIC) (required) OR
Current, unrestricted license in the State of Washington as a Mental health Counselor (LMHC), Mental Health Professional (LMHP), or Marriage and Family Therapist (LMFT) (required)
Have a minimum of one (1) year case management experience; home health or discharge planning experience; or a combination of education and experience which provides an equivalent background required OR
Have a minimum of one (1) year in an acute care, facility-based medical or behavioral health experience and/or outpatient psychiatric and substance abuse disorder treatment experience, required; or equivalent combination of education and experience and/or working with children and families
Have experience with those who have disabilities and knowledge of Child and Families Services
Have a minimum three (3) years of clinical experience and/or outpatient setting (required)
Have a valid state issued drivers' license
Preferred
Have a case management certification
Are bilingual
Have experience in managed care (Medicaid/HCA)
Have previous experience in using Care Management software applications
Have knowledge of, and experience with, community resources
Experience in care management workflow systems
Benefits
Medical, Prescription, Dental, and Vision
Telehealth app
Flexible Spending Accounts, Health Savings Accounts
Basic Life AD&D, Short and Long-Term Disability
Voluntary Life, Critical Care, and Long-Term Care Insurance
401(k) Retirement and generous employer match
Employee Assistance Program and Mental Fitness app
Financial Coaching, Identity Theft Protection
Time off including PTO accrual starting at 17 days per year
40 hours Community Service volunteer time
10 standard holidays, 2 floating holidays
Compassion time off, jury duty
Company
Community Health Plan of Washington
For over 30 years, Community Health Plan of Washington (CHPW) has been providing quality health care to Washington families and supporting your choices for health care.
501-1000 employees
Funding
Current Stage
Late StageLeadership Team
Leanne Berge
Chief Executive Officer
Stacy Kessel, CPA
Chief Financial Officer
Recent News
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