Join to apply for the Case Manager I role at Community Health Plan of Washington .
Case Manager I
Responsible for the operational delivery of the plan's case management and coordination programs and processes. Provides case management services for CHPW members with short‑term, long‑term, stable, unstable, and predictable course of illness, and/or highly complex medical/behavioral and social conditions. The goal is to improve members' quality of life and ensure cost‑effective outcomes by using internal and community‑based resources. The Case Manager level will be determined by the hiring manager based on education, previous experience, and demonstrated leadership skills.
Qualifications
Bachelor's degree in nursing, or a master's degree in social work and/or related behavioral health field (preferred)
Current, unrestricted license in the State of Washington as a registered nurse (RN) (required) OR 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)
Minimum of one (1) year case management, home health or discharge planning experience; or a combination of education and experience which provides an equivalent background required
Minimum of one (1) year facility‑based medical or behavioral health experience and/or outpatient psychiatric and substance abuse/substance abuse disorder treatment experience required; or equivalent combination of education and experience and/or working with children and families. Experience with those who have disabilities and knowledge of Child and Families Services
Minimum three (3) years of clinical experience in an acute care and/or outpatient setting (required)
Experience and proficiency with Microsoft Office products
Possess a Case Management Certification (preferred)
Have Bilingual abilities (preferred)
Responsibilities
Perform telephonic case management for members with acute, chronic, and complex needs.
Advocate on behalf of members and facilitate coordination of resources required to help members reach optimum functional levels and autonomy within the constraints of their disease conditions.
Work within a multi‑functional team to connect 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.
Assess, evaluate, plan, implement, and document care of members within the organization's clinical database system, in accordance with organizational policies and procedures.
Assess members, including identifying and coordinating access to the appropriate level of care and treatment. Use assessment information to assign the appropriate risk and complexity level, and create and document a care plan in coordination with the member, family and health team input.
Initiate a plan of care based on member‑specific needs, assessment data and the medical/behavioral plan of care. Goals for members are measurable and developed in conjunction with the patient/family to improve quality of life.
Plan care in collaboration with members of the multidisciplinary team, and consider the physical, behavioral, cultural, and other factors affecting the member's health status and care needs.