The Care Manager supports maternity members through personalized care coordination and case management, helping them achieve optimal health through self-management. This role involves engaging with members, caregivers, and providers to assess needs, develop care plans, and set individual health goals.
Work Arrangement:
* Remote - Associate must be located in Ohio.
Responsibilities:
* Assess members to determine care coordination and case management needs for all referred members.
* Completes comprehensive person-centered assessment of physical health, psycho-social health, and environmental health as social determinants of health and supportive needs.
* Identifies problems/barriers for care coordination and appropriate care management interventions.
* Coordinates physical, behavioral health, and social services.
* Provides medication management, including regular medication reconciliation and support of medication adherence.
* Creates a plan of care to assist members in reducing/resolving problems and or barriers so that members may achieve their optimal level of health.
* Identifies both short—and long-term goals and associated time frames for completion. Shares goals with the member and caregiver as needed.
* Identifies and implements the appropriate level of intervention based on the member’s needs and clinical progress.
* Schedules follow-up calls as necessary and makes appropriate referrals. Implements actions to address member issues.Documents progress towards meeting goals and resolving problems.
* Coordinates care and services.
Education & Experience:
* Minimum of 3 years of professional practice working with maternal health within an acute care, community health, or ambulatory care setting.
* Case management experience, preferably within a managed care organization, is desired.
Licensure:
* A current and unrestricted Registered Nurse (RN) or Licensed Independent Social Worker (LISW) in Ohio or multi-state compact licensure is required.
* Valid driver’s license and car insurance required.
Skills & Abilities:
* Ability to work independently and collaboratively in a fast-paced, dynamic environment, showing adaptability and flexibility to change.
* Skilled in working effectively with culturally and demographically diverse populations. Strong organizational and time management abilities, with a proven capacity to prioritize and manage multiple tasks efficiently.
* Experienced in assessing member needs, developing care plans, and supporting self-management strategies.
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