Organization: Access Management Services, LLC / Colorado AccessTitle: Care Manager
Categories: Nonprofit Jobs
Organization Type: 501(c)(4)
Wouldn’t it be nice to work for a company where the mission makes sense, the salaries are competitive, the company listens to the needs of the employees and the office is professional yet the dress is casual?
Access Management Services is a health care services and support company serving Colorado Access and its subsidiaries. Colorado Access is a nonprofit health plan supporting the medical, behavioral, and long term care needs of more than 500,000 Coloradans. Its subsidiary company offers commercial health plans as Access Health Colorado on the Connect for Health Colorado insurance marketplace, as well as commercial employer health plan administration services as Access Health Benefit Solutions. The subsidiary AccessCare is a platform for on-demand tele-behavioral health technology and services. We offer an excellent benefit and compensation package, including medical, dental & vision, 401(k), tuition reimbursement, and generous PTO.
We are currently looking for Care Managers (Care Managers, RN Care Managers, Community-Based Care Managers) responsible for working in collaboration with the Coordinated Clinical Services team to assist in identifying members through health risk questionnaires who may require care coordination. Care coordination responsibility encompasses working directly with members, families and providers over time to assist in arranging and managing a complex set of resources required to maintain health and function. Cases managed by this professional require complex decision making.
Essential Functions Summary:
· Assists, with input from RN/Supervisor, in the identification of members needing care coordination.
· Identifies risk factors leading to increased utilization and works toward reduction of preventable hospital admissions, re-admissions, excessive therapies, DME, etc.
· Works in conjunction with the RN/Supervisor to develop identified individualized interventions for members in care management
· Assures appropriate and complete data entry of all requests per guidelines.
· Participates in Health Promotion activities for members who do not meet criteria for intensive care management.
· Performs individual health risk questionnaires, assists with individualized care plan design, documentation and implementation of care plan activity, and evaluation of outcomes.
· Submits completed member health risk questionnaires and any referrals from Customer Service, Provider Relations, Coordinated Clinical Services and other outside agencies and practitioners to the RN/Supervisor for review.
· Attends member appointments and meets with members in a variety of settings as needed to assist in obtaining completed questionnaires and coordination of care in conjunction with provider and provider staff.
· Master’s degree or license in a health related field required.
· Knowledge of managed care, case management and utilization management is required.
· Ability to travel to and work independently in clinic sites and conduct home visits.
· Three years of clinical, case management and/or healthcare experience is required.
· Experience working with Medicare and Medicaid populations, and related social/economic issues preferred.
· Experience with utilization review and quality improvement processes desired.
· If licensed, a current unrestricted Colorado license as a healthcare professional is required.
· A valid Driver’s License is required.
Hiring decisions will be made without regard to race, creed, color, national origin, sex, marital status, religion, ancestry, mental or physical handicap, age, veteran’s status, disability, or sexual orientation. EOE.
Interested applicants should apply online through our website at http://www.coaccess.com/careers.
This is a posting on Colorado Nonprofit Association’s Career Center.