Case Manager - Health Coordinator (Keaau)
Full Time
Kea‘au, HI 96749
Posted
Job description
Job Summary
The Health Coordinator (HC) will provide health coordination services for HMSA QUEST and Dual Special Needs Plan (DSNP) members.
A HC is an individual who is part of a multi-disciplinary team who coordinates, monitors, and ensures that appropriate and timely care is provided to the member. The HC is responsible for assessing member needs, developing a person-centered Health Action Plan (HAP), and facilitating the delivery of appropriate physical and behavioral health services across the continuum of the health coordination services.
This position is a field-based role and will spend much of the time in the community or working from home. This may also include but is not limited to healthcare facilities, patient residences, and outpatient offices.
A HC is an individual who is part of a multi-disciplinary team who coordinates, monitors, and ensures that appropriate and timely care is provided to the member. The HC is responsible for assessing member needs, developing a person-centered Health Action Plan (HAP), and facilitating the delivery of appropriate physical and behavioral health services across the continuum of the health coordination services.
This position is a field-based role and will spend much of the time in the community or working from home. This may also include but is not limited to healthcare facilities, patient residences, and outpatient offices.
Duties and Responsibilities
- Conduct timely face to face health functional/risk assessments and develop, document, and implement targeted health action plans/care plans based on the results of the assessment for members requiring assistance with care coordination.
- Coordinate a multi disciplinary team to develop a person- centered health action plan/care plan to include but not limited to member's PCP, other service providers as appropriate, the member, and others determined by the member including family members, caregivers, and significant others in order to ensure timely access to appropriate medical care and services.
- Document and resolve issues for eligible HMSA members and providers on appropriate electronic systems.
- Provide continuity of care when members are discharged from a hospital to avoid re-admissions
- Coordinate and monitor activities among internal departments, external community agencies including DHS, Medicare, and the DOH programs excluded from QUEST Integration, as well as HMSA partners/vendors.
- Utilize compiled data received from member encounters to assure the services provided meet the member's needs.
- Assist manager in updating or establishing new policies and procedures as needed or identified.
- Provide assistance in resolving any concerns about service delivery or providers.
- Performs all other miscellaneous responsibilities and duties as assigned or directed.
Exempt or Non-Exempt
Exempt
Minimum Qualifications
- Must meet all State certification and licensure requirements for a social worker, licensed nurse, or other healthcare professional
- (Health care professional is defined as a physician, podiatrist, optometrist, psychologist, dentist, physician assistant, physical or occupational therapist, speech-language pathologist, audiologist, registered nurse, license clinical social worker, nurse practitioner, or any other licensed or certified professional who meets the state requirements of a health care professional).
- One year of relevant healthcare experience.
- Exhibit cultural sensitivity to people of various ethnic origins and socioeconomic backgrounds.
- Effective written and oral communication skills.
- Effectively solve practical problems and deal with a variety of unique situations where only limited standardization exists.
- Must possess a valid driver's license, with access to an automobile with current license, registration, and no-fault insurance.
- Requires safely operating an insured automobile for travel to off-site locations to conduct and accomplish business related activities.
- Basic knowledge of Microsoft Office applications. Including but not limited to Word, Excel, and Outlook.
- Ability to travel to the neighbor islands.
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