Community Based Care Manager I - Indiana

• Collaborate with facility-based case managers and providers to create post-discharge care plans and facilitate timely transitions to appropriate levels of care.
• Identify and implement effective interventions based on opportunities identified in the member's post discharge care plan.
• Coordinate, communicate, and collaborate with members and the ICT to achieve goals and maximize positive outcomes.
• Facilitate regularly scheduled interdisciplinary care team (ICT) meetings as needed to address member needs.
• Develop and regularly update transition plans in collaboration with the ICT, based on member preferences and needs.
• Identify and manage barriers to achieving care plan goals.
• Identify and implement effective interventions based on opportunities identified in the member's post discharge care plan.
• Empower members to manage and improve their health, wellness, safety, adaptation, and self-care through effective care coordination and case management.
• Educate members, caregivers and providers about options, community resources, and benefits for informed decision-making.
• Evaluate member and provider satisfaction through open communication and monitoring of concerns or issues.
• Coordinate with community-based case managers and other service providers to ensure effective coordination and avoid duplication of services.
• Document care coordination activities and member responses in a timely manner according to professional standards and CareSource policies.
• Ensure timely transfer of member health information between providers and other MCEs as applicable
• Ensure timely communication of prior authorization between MCEs as applicable
• Continuously assess for process improvement opportunities to enhance the member and provider experience.
• Adhere to NCQA and CMSA standards.
• Perform any other job related duties as requested.

• High School or GED required
• Completion of State Approved Licensed Practical Nurse Program required
• Three (3) years of experience in a healthcare field (i.e., discharge planning, case management, care coordination and/or home/community health management experience) required
• Medicaid and/or Medicare managed care experience preferred

• Strong understanding of Quality, HEDIS, disease management, supportive medication reconciliation and adherence
• Intermediate proficiency level with Microsoft Office, including Outlook, Word and Excel
• Ability to communicate effectively with a diverse group of individuals
• Ability to multi-task and work independently within a team environment
• Knowledge of local, state and federal healthcare laws and regulations and all company policies regarding case management practices
• Adhere to code of ethics that aligns with professional practice
• Knowledge of and adherence to Case Management Society of America (CMSA) standards for case management practice
• Strong advocate for members at all levels of care
• Strong understanding and sensitivity of all cultures and demographic diversity
• Ability to interpret and implement current research findings
• Awareness of community and state support resources
• Critical listening and thinking skills
• Decision making and problem-solving skills
• Strong organizational and time management skills

• Current, unrestricted license as a Licensed Practical Nurse (LPN) required
• Must have valid driver's license, vehicle and verifiable insurance. Employment in this position is conditional pending successful clearance of a driver's license record check. If the driver's license record results are unacceptable, the offer will be withdrawn or, if employee has started employment in position, employment in this position will be terminated
• To help protect our employees, members, and the communities we serve from acquiring communicable diseases, Influenza vaccination is a requirement of this position. CareSource requires annual proof of Influenza vaccination for designated positions during Influenza season (October 1 - March 31) as a condition of continued employment. Employees hired during Influenza season will have thirty (30) days from their hire date to complete the required vaccination and have record of immunization verified.
• CareSource adheres to all federal, state, and local regulations. CareSource provides reasonable accommodations to qualified individuals with disabilities or medical conditions, sincerely held religious beliefs, or as required by state law to enable the employee to perform the essential functions of the position. Request for accommodations will be completed through an interactive review process.

• This is a mobile position, meaning that regular travel to different work locations, including homes, offices or other public settings, is essential.
  Will be exposed to weather conditions typical of the location and may be required to stand and/or sit for long periods of time.
  Must reside in the same territory they are assigned to work in; exceptions may be considered, due to business need
  May be required to travel greater than 50% of time to perform work duties.
  Required to use general office equipment, such as a telephone, photocopier, fax machine, and computer
  Flexible hours, including possible evenings and/or weekends as needed to serve the needs of our members
  
• Over 50% (Mobile) Routine travel required

Compensation Range:
$54,500.00 - $87,300.00 CareSource takes into consideration a combination of a candidate's education, training, and experience as well as the position's scope and complexity, the discretion and latitude required for the role, and other external and internal data when establishing a salary level. In addition to base compensation, you may qualify for a bonus tied to company and individual performance. We are highly invested in every employee's total well-being and offer a substantial and comprehensive total rewards package.

Compensation Type:
Hourly

Competencies:
- Fostering a Collaborative Workplace Culture
- Cultivate Partnerships
- Develop Self and Others
- Drive Execution
- Influence Others
- Pursue Personal Excellence
- Understand the Business

This job description is not all inclusive. CareSource reserves the right to amend this job description at any time. CareSource is an Equal Opportunity Employer. We are dedicated to fostering an environment of belonging that welcomes and supports individuals of all backgrounds.

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