Care Manager, Mom and Baby

🔥 16 hours ago

🎸 Mississippi – Remote

🎸 Mississippi – Remote

💵 $56.4k - $90.4k / year

⏰ Full Time

🟡 Mid-level

🟠 Senior

👔 Manager

🦅 H1B Visa Sponsor

This company has sponsored H1B visas in the past.

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CareSource

WebsiteLinkedInAll Job Openings

1001 - 5000 employees

Founded 30+ years

🏥 Healthcare

🛡️ Insurance

⚕️ Healthcare Insurance

Healthcare • Insurance • Healthcare Insurance

CareSource is a health services company focused on providing affordable health insurance and healthcare solutions. It offers a wide range of plans including Medicaid, Marketplace, and Medicare Advantage, targeting low-income adults, families, children, pregnant women, elderly adults, and people with disabilities. Additionally, CareSource provides members with resources for COVID-19 support, dental, vision, and hearing benefits, as well as pharmacy services. The company emphasizes easy access to healthcare management through online platforms and a mobile app.

📋 Description

• Collaborate with interdisciplinary care teams, providers, community organizations, and faith-based organizations • Engage members and natural supports through strength-based, trauma-informed assessments and motivational interviewing • Complete health, psychosocial, behavioral, and health-equity assessments • Facilitate interdisciplinary care team meetings • Establish professional member relationships through telephonic or electronic communication • Develop and update individualized, person-centered care plans • Identify and manage barriers to care-plan goals • Implement interventions based on clinical standards and best practices • Coordinate care and case management to support members’ health, wellness, safety, adaptation, and self-care • Educate members and natural supports about treatment options, community resources, and insurance benefits • Document and evaluate member responses and progress • Monitor member satisfaction and address concerns • Promote effective healthcare-resource utilization through clinical variance and benefits management • Verify member eligibility, enrollment history, demographics, and current health status • Coordinate psychosocial and behavioral assessments and care planning • Inform providers about Care Management services and member benefits • Assist with ICDS model-of-care orientation and training for facility and community providers • Identify and address gaps in care and access • Coordinate post-discharge care and transitions to appropriate levels of care • Coordinate with community organizations, state agencies, and service providers to avoid duplication • Adjust intervention intensity according to guidelines, member preferences, healthcare needs, and care-plan progress • Terminate care coordination services according to case-closure guidelines • Provide clinical oversight and direction to unlicensed team members as appropriate • Document care coordination activities according to professional standards and CareSource policies • Identify process improvements and share them with leadership • Adhere to NCQA and CMSA standards • Perform other job-related duties as requested

🎯 Requirements

• Associates of Science (A.S) degree from an accredited nursing program required, or Bachelor's degree in healthcare field required • Equivalent years of relevant work experience may be accepted in lieu of required education • Three (3) years experience in nursing, social work, counseling, or a healthcare profession required • Three (3) years Medicaid and/or Medicare managed care experience preferred • Current unrestricted clinical license in state of practice as a Registered Nurse, Social Worker, or Professional Clinical Counselor required • Licensure may be required in multiple states as applicable based on State requirements of the work assigned • Case Management Certification highly preferred • Strong understanding of Quality, HEDIS, disease management, supportive medication reconciliation, and adherence • Intermediate proficiency with Microsoft Office, including Outlook, Word, and Excel • Ability to communicate effectively with a diverse group of individuals • Ability to multitask and work independently within a team environment • Knowledge of local, state, and federal healthcare laws and regulations and company case management policies • Adherence to professional code of ethics and CMSA case management standards • Strong understanding and sensitivity of cultures and demographic diversity • Ability to interpret and implement current research findings • Awareness of community and state support resources • Critical listening, thinking, decision-making, problem-solving, organizational, and time-management skills

🏖️ Benefits

• Bonus tied to company and individual performance may be available • Comprehensive total rewards package • Flexible hours, including possible evenings and/or weekends • Travel is not typically required

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