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Case Manager

Springfield Contractor
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Job Description:

  • Responsible for health care management and coordination of Client Healthcare members in order to achieve optimal clinical, financial and quality of life outcomes.
  • Works with members to create and implement an integrated collaborative plan of care. Coordinates and monitors Client member’s progress and services to ensure consistent cost effective care that complies with Client policy and all state and federal regulations and guidelines.


Essential Functions:

  • Provides case management services to members with chronic or complex conditions including:
  • Proactively identifies members that may qualify for potential case management services.
  • Conducts assessment of member needs by collecting in-depth information from Client’s information system, the member, member’s family/caregiver, hospital staff, physicians and other providers. o Identifies, assesses and manages members per established criteria.
  • Develops and implements a case management plan in collaboration with the member, caregiver, physician and/or other appropriate healthcare professionals to address the member needs. o Performs ongoing monitoring of the plan of care to evaluate effectiveness.
  • Documents care plan progress in Client’s information system.
  • Evaluates effectiveness of the care plan and modifies as appropriate to reach optimal outcomes. o Measures the effectiveness of interventions to determine case management outcomes.
  • Promotes integration of services for members including behavioral health and long term care to enhance the continuity of care for Client members. • Conducts face to face or home visits as required.
  • Maintains department productivity and quality measures. • Manages and completes assigned work plan objectives and projects in a timely manner.
  • Demonstrates dependability and reliability. • Maintains effective team member relations. • Adheres to all documentation guidelines.
  • Attends regular staff meetings. Participates in Interdisciplinary Care Team (ICT) meetings. • Assists orientation and mentoring of new team members as appropriate.
  • Maintains professional relationships with provider community and internal and external customers. • Conducts self in a professional manner at all times.
  • Maintains cooperative and effective workplace relationships and adheres to company Code of Conduct.
  • Participates in appropriate case management conferences to continue to enhance skills/abilities and promote professional growth.
  • Complies with required workplace safety standards.


Required Education:

  • Bachelor’s degree in Nursing or Masters degree in Social Work, or Health Education (a combination of experience and education will be considered in lieu of degree).


Required Experience:

  • 0-2 years of clinical experience with case management experience.


Required Licensure/Certification:

  • Active, unrestricted State Registered Nursing license or Licensed Clinical Social Worker LCSW or Advanced Practice Social Worker APSW in good standing.
  • A combination of experience and education will be considered in lieu of LCSW or APSW. Must have valid driver’s license with good driving record and be able to drive locally.

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Skills required

Confidentiality
Mental Health
Crisis Intervention
Social Services
Licensed Master Social Worker
Psychosocial Treatment
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