Oct 30, 2019
WellCare Health Plans This field based position coordinates care for WellCare members in the community. This position must work collaboratively with multidisciplinary care teams that may include the member's PCP, specialists, social worker/behavioral health specialist and community resource contacts, while functioning with professional autonomy under the supervision of the Care Coordination leadership team. This position performs appropriate assessments, organizes, reviews and reports health and social information through member home visits. Individuals in this position demonstrate cultural sensitivity, effective communication and motivational interviewing skills. Reports to: Supervisor, Field Care Management Department: Care Management Position Location : Knoxville, Fulton, Peoria, Pekin, IL Essential Functions: Manage an assigned caseload of WellCare members while remaining in compliance with all internal and regulatory requirements. Create relationships with all assigned members working towards their optimal overall health and well-being. Be the system navigator and single point of contact for members and families Conduct complete, timely and accurate program specific assessments (face-to-face). Develop and maintain a person-centered care plan or family driven care plan for all members in assigned caseload involving the members PCP, family/caregiver, Social Worker/Behavioral Health specialists and other specialists as needed to evaluate the individuals' needs, goals, and plan of action. Complete all activities and interventions outlined in the members care plan and ongoing monitoring of cases to ensure routine follow up and progression in their care plan goals, Capacity to drive self to members' homes and facilities and must comply with WellCare's travel and mileage reimbursement policies. Facilitate ICT activities with members and their identified support team and maintain strong communication with the members' care team. Maintain HIPAA standards and confidentiality of protected health information. Perform other duties as assigned Additional Responsibilities: Candidate Education: Bachelor's degree with a concentration in healthcare or related field or Fellow, Academy for Healthcare Management (AHM) Designation is required At least 6 months to one year experience in a clinical, mental health or managed care setting is preferred Candidate Experience: Must demonstrate customer-focused interpersonal skills to interact in an effective manner with practitioners, the interdisciplinary health care team, community agencies, members, and families with diverse opinions, values, and religious and cultural ideals. Must also demonstrate the ability to work autonomously, follow through with delegated tasks and be directly accountable for deliverables. Must have leadership qualities including time management, verbal and written communication skills, listening skills, problem solving and decision-making, priority setting, work delegation and work organization, as well as strong customer service focus, teamwork orientation and resourcefulness in problem solving. Candidate Skills: Demonstrates excellent communication - both verbal and written Strong organizational and follow up skills Experience working with Inner City, Suburban and Rural neighborhood members Excellent interpersonal and facilitation skills Licenses and Certifications: A license in one of the following is required: Required Other CPR Certified Preferred Certified Case Manager (CCM) Preferred Other Licensed Behavioral Professional i.e. RN, LCSW, LMHC, LMFT About us Headquartered in Tampa, Fla., WellCare Health Plans, Inc. (NYSE: WCG) focuses primarily on providing government-sponsored managed care services to families, children, seniors and individuals with complex medical needs primarily through Medicaid, Medicare Advantage and Medicare Prescription Drug Plans, as well as individuals in the Health Insurance Marketplace. WellCare serves approximately 5.5 million members nationwide as of September 30, 2018. WellCare is a Fortune 500 company that employs nearly 12,000 associates across the country and was ranked a "World's Most Admired Company" in 2018 by Fortune magazine. For more information about WellCare, please visit the company's website at www.wellcare.com. EOE: All qualified applicants shall receive consideration for employment without regard to race, color, religion, creed, age, sex, pregnancy, veteran status, marital status, sexual orientation, gender identity or expression, national origin, ancestry, disability, genetic information, childbirth or related medical condition or other legally protected basis protected by applicable federal or state law except where a bona fide occupational qualification applies. Comprehensive Health Management, Inc. is an equal opportunity employer, M/F/D/V/SO.
Professional Diversity Network Illinois, USA Full-Time