JSG is seeking two Clinical Care Managers in the state of California that will perform comprehensive assessments, develop individualized care planning, initiate, and coordinate interdisciplinary case conferences with providers of service, support members in creating and adhering to person-centered care plans. Additionally, the Clinical Case Manager will be coordinating services with other departments, providers, programs, and community partners, as needed, to provide support.
Responsibilities
Manage a panel of assigned members to guide along the continuum of care to the optimal functional level and quality of life.
Conduct comprehensive assessments and annual or as needed re-assessments of the member’s psychosocial, physical health, functional abilities, and social determinants of health.
Develop an individualized care plan based on assessment information that is member-centered, comprehensive and consistent with program guidelines and policies and procedures.
Identify member’s need for programs, Behavioral Health Services, community supports and other services to fill gaps in care, monitors effectiveness of services.
Conduct outreach to member for care plan review, needs assessment and acuity monitoring.
Establish and maintain open and effective communication with physicians and other health care and social service workers.
Provide appropriate information on all significant aspects of member’s care and program operations, while maintaining necessary confidentiality.
Maintain necessary and complete documentation for all case management activities in the plan’s case management system.
Lead and/or participate in clinical huddles and interdisciplinary care team meetings with internal HPSM staff and external partners and providers.
Make referrals to various departments, community-based organizations, and governmental agencies when health and/or psychosocial condition(s) indicate need for appropriate referrals(s).
Promote clear communication amongst the care team, which can include family and community supports, and treating providers by ensuring awareness regarding member care plans, and when supporting care transitions.
Teach appropriate interventions, link to resources, educate about benefits, and discuss medication effects and side effects to patient, caregiver, volunteers, and others as appropriate.
Adhere to case management practice standards at all times.
Participate in continuous quality improvement efforts.
Maintain knowledge of benefits, programs, and processes, in order to provide clear information to member and providers.
Maintain knowledge of community resources and programs.
Maintain working knowledge of confidentiality practices and standards. Adheres to all standards of confidentiality and patient health information.
Qualifications
Bachelor or Associate’s degree.
Two (2) years clinical experience.
Three (3) years of managed care experience preferably in Care Coordination.
Experience working with the health needs of the population served.
At least one (1) year of direct Care Coordination experience.
Valid California license as an RN, LCSW, LMFT. PHN preferred. Will consider unlicensed Masters Level Social Worker (MSW/ASW).
Certification as Certified Case Manager (CCM) preferred.
Pay rate: $45-$58 per hour.
Benefits: JSG offers medical, dental, vision, life insurance options, short-term disability, 401(k), weekly pay, and more.
Johnson Service Group (JSG) is an Equal Opportunity Employer. JSG provides equal employment opportunities to all applicants and employees without regard to race, color, religion, sex, age, sexual orientation, gender identity, national origin, disability, marital status, protected veteran status, or any other characteristic protected by law.