Community Health Care Manager
Community Health Care Managers (CHCM’s) work with members enrolled in Medicaid to coordinate care and to connect them with essential community resources through partnerships with local physical and behavioral health providers. CHCM’s aim to enhance individual health outcomes and the overall healthcare experience by identifying each person’s health and wellness goals and improving their ability to navigate the healthcare system while also working to reduce high healthcare utilization costs. The CHCM reports to the CHCM Supervisor.
Skills & Abilities
Skills to communicate and interact appropriately and respectfully across multi-cultural .
Strong critical thinking and problem solving abilities.
Strong verbal communication skills (both over the phone and in-person).
Basic Business writing skills.
Strong customer service skills.
Ability to multi-task, prioritize, and handle multiple priorities while meeting deadlines.
Computer skills including Microsoft Office (Outlook/Excel/Word), state administered data collection systems, and other programs as needed or requested.
Experience working with EMRs.
Experience partnering with local and regional health and human service resources (not required).
Experience working with Medicaid and Medicare (not required).
Ability to effectively engage and build rapport in a variety of medical, behavioral health, justice involved, substance use, and homeless situations.
Strict Confidentiality required.
Bilingual (not required).
Reliable transportation and a valid driver license and insurance.
Education or Formal Training
HS Graduate or GED required.
Licensure/Certifications
Valid Colorado Driver License and Insurance required.
Work Environment Physical Requirements
Annual Influenza vaccination required for all employees.
Frequent contact with the public by phone and in person.
Sitting for periods of time while utilizing a PC or laptop.
Standing for periods of time on uneven ground at times.
Walking for periods of time on uneven ground at times.
Climbing up and down stairs.
Bending and reaching.
Lifting up to 30 pounds.
May be exposed to weather elements such as heat, rain, snow, etc. during member engagements.
Work in spaces within proximity to other staff, noise, and discussions.
Job Responsibilities / Essential Functions
Case Management and Care Coordination of assigned members.
Monitor members according to guidelines set by NCHA Policy and Procedure under the Care Management guidelines.
Participate in home visits, telephone contacts, office/hospital visits, and other means of connecting with members to reach identified goals.
Perform needs assessments and identify risk factors to develop person centered care plans.
Assist members in scheduling appointments, follow-up care, referrals, medication refills, etc.
Attend member appointments with providers and community resources as needed.
Participate in health promotion and health education activities for members as identified in their health care plan.
Facilitate collaboration, communication, and coordination among all members of an individual’s multidisciplinary healthcare team, while ensuring consistent and ongoing correspondence.
Optimize member and family self-management through education, community resources, and support.
Review appropriate cost‑effective care and decrease duplication of services for members.
Enter all documentation, contacts, and assessments into multiple databases with a high level of accuracy.
Timely responsiveness to emails, calls, and requests.
Understand, communicate, and facilitate member’s complaints, grievances, and appeal processes.
Regular case reviews with supervisor.
Strict confidentiality of member records and communications following HIPAA Law.
Expected to develop competencies through ongoing education and professional development.
Focus on meeting individuals “where they are at”.
Support individuals in improving their understanding of how to access and use local resources for self‑managing their health and wellness.
Educate members on how to navigate the healthcare system.
Able to work independently and in a busy office environment that may contain interruptions to work due to walk‑ins, member needs, supervisor requests, phone conversations, etc.
Able to manage stressful situations while remaining calm and non‑reactive (i.e. working with members who may have severe and persistent mental health issues or substance use disorders).
Able to utilize positive problem solving in difficult situations.
Other Duties as Assigned
Provide assistance as designated by Care Management leadership to support the overall goals and operational needs of NCHA, such as on‑the‑job shadowing, staff relief, or other needs.
Provide input into development of procedures and be accountable for adhering to them.
Adhere to all programs designed to ensure due diligence in preventing, identifying, and reporting any unlawful or unethical behavior by colleagues, professional partners, or agents.
Participation in ongoing performance improvement activities.
Provide oversight to students or guests wanting to learn about care management.
Other duties as needed to meet demands of the organization (may include flexing or changing job location).