CareSource · 1 month ago
Care Manager Transitions of Care
United States
Full-time
Remote
Mid Level
$63K/yr - $100K/yr
3+ years expCareSource is a management services organization dedicated to improving the quality of care for its members. The Care Manager collaborates with various stakeholders to enhance member care through assessments and person-centered planning, aiming to address health needs and improve overall member outcomes.
Health CareMedicalNon Profit
Responsibilities
Engage the member and their natural support system through strength-based assessments and a trauma-informed care approach using motivation interviewing to complete health and psychosocial assessments through a health equity lens unique to the needs of each member that identify the cultural, linguistic, social and environmental factors/determinants that shape health and improve health disparities and access to public and community health frameworks
Facilitate regularly scheduled inter-disciplinary care team (ICT) meetings to meet the needs of the member
Engage with the member to establish an effective, professional relationship via telephonic or electronic communication
Develop and regularly update a person-centered individualized care plan (ICP) in collaboration with the ICT, based on member’s desires, needs and preferences
Identify and manage barriers to achievement of care plan goals
Identify and implement effective interventions based on clinical standards and best practices
Assist with empowering the member to manage and improve their health, wellness, safety, adaptation, and self-care through effective care coordination and case management
Facilitate coordination, communication and collaboration with the member the ICT in order to achieve goals and maximize positive member outcomes
Educate the member/ natural supports about treatment options, community resources, insurance benefits, etc. so that timely and informed decisions can be made
Employ ongoing assessment and documentation to evaluate the member’s response to and progress on the ICP
Evaluate member satisfaction through open communication and monitoring of concerns or issues
Monitors and promotes effective utilization of healthcare resources through clinical variance and benefits management
Verify eligibility, previous enrollment history, demographics and current health status of each member
Completes psychosocial and behavioral assessments by gathering information from the member, family, provider and other stakeholders
Oversee (point of contact) timely psychosocial and behavioral assessments and the care planning and execution of meeting member needs
Participate in meetings with providers to inform them of Care Management services and benefits available to members
Assists with ICDS model of care orientation and training of both facility and community providers
Identify and address gaps in care and access
Collaborate with facility-based healthcare professionals and providers to plan for post-discharge care needs or facilitate transition to an appropriate level of care in a timely and cost-effective manner
Coordinate with community-based organizations, state agencies, and other service providers to ensure coordination and avoid duplication of services
Adjust the intensity of programmatic interventions provided to member based on established guidelines and in accordance with the member’s preferences, changes in special healthcare needs, and care plan progress
Appropriately terminate care coordination services based upon established case closure guidelines for members not enrolled in contractually required on going care coordination
Provide clinical oversight and direction to unlicensed team members as appropriate
Document care coordination activities and member response in a timely manner according to standards of practice and CareSource policies regarding professional documentation
Continuously assess for areas to improve the process to make the members’ experience with CareSource easier and shares with leadership to make it a standard, repeatable process
Adherence to NCQA and CMSA standards
Perform any other job duties as requested
Qualification
Required
Nursing degree from an accredited nursing program or Bachelor's degree in a health care field or equivalent years of relevant work experience is required
A minimum of three (3) years of experience in nursing or social work or counseling or health care profession (i.e. discharge planning, case management, care coordination, and/or home/community health management experience) is required
Current unrestricted clinical license in state of practice as a Registered Nurse, Social Worker or Professional Clinical Counselor is required. Licensure may be required in multiple states as applicable based on State requirement of the work assigned
Preferred
Advanced degree associated with clinical licensure is preferred
Three (3) years Medicaid and/or Medicare managed care experience is preferred
Case Management Certification is highly preferred
Benefits
You may qualify for a bonus tied to company and individual performance
Substantial and comprehensive total rewards package
Company
CareSource
CareSource provides managed care services to Medicaid beneficiaries.
1001-5000 employees
H1B Sponsorship
CareSource has a track record of offering H1B sponsorships. Please note that this does not
guarantee sponsorship for this specific role. Below presents additional info for your
reference. (Data Powered by US Department of Labor)
Distribution of Different Job Fields Receiving Sponsorship
Represents job field similar to this job
Trends of Total Sponsorships
2025 (30)
2024 (39)
2023 (35)
2022 (21)
2021 (37)
2020 (28)
Funding
Current Stage
Late StageTotal Funding
unknownKey Investors
FHLB Cincinnati
2026-01-17Grant
Leadership Team
Erhardt Preitauer
President & Chief Executive Officer
Jason Bearden
Market President and CEO, Georgia
Recent News
2026-01-18
Dayton Daily News
2025-12-17
Company data provided by crunchbase