Top 809 Managment Jobs

Case Managment Clinitian
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Case Managment Clinitian

Safe Space Chico
Chico, CA

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Job Details

Full-time
From $60 an hour
8 days ago

Qualifications

Collaborate with healthcare professionals
Teamwork
Management
Medicare
Case assessment
RN License
Interpersonal skills
Chronic disease management
Writing skills
HIPAA
Health insurance knowledge
Medicare regulations
Health information regulatory compliance
Managing projects
Medicaid regulations
Medicaid
Productivity software
Clinical confidentiality policies
Associate's degree
Associate Degree in Nursing
Managing patients as a clinical case manager
Hospital experience

Full Job Description

Job Summary for the Case Work Clinician: Clinical Oversight of the ECM Program

The Clinical Oversight position of the Enhanced Care Management (ECM) Program is responsible for the oversight activities associated with Safe Space Winter Shelter’s ECM service network.  The position is responsible for providing oversight, feedback, and technical assistance to ECM staff members to support effective delivery of ECM services and ensure compliance with local, State, and Federal regulations, statues and guidelines. The position is responsible for conducting regular meetings with staff, reviewing Assessments & Care Plans, providing guidance on clinical best practices, and assisting with escalation of cases that require additional assistance. The position works directly with Care Management staff to inform capacity-building and training activities related to the ECM Program operations.

Duties:

Conduct regular monitoring and coaching with Providers to review aggregate progress and individual ECM member cases. May use telephonic, onsite, or written methods of ECM staff activities to monitor performance related to staff clinical and service requirements. Provide guidance on best practices to ECM staff.
Conduct a monthly random sample review of Assessments and Care Plans created by the ECM staff. Identify any gaps in the Care Plan services or regulatory compliance and provide coaching and feedback to the staff to improve.  Identify any issues that require escalation or more frequent monitoring of the ECM Provider. Organize and perform file review process in accordance with given criteria to include collection & verification of supporting documentation, recording received information in appropriate tracking systems and communicating end results of requests in writing and/or verbally.
Provide training, education and consultation as necessary to ECM staff. Collaborate with other ECM staff to identify topics and develop materials for staff training and capacity building.
Assist ECM staff with escalation of ECM member cases that require additional assistance.
Actively identifies and implements efforts to improve the quality, effectiveness and efficiency of ECM.  Assist co-workers with special projects or work volume as required. Communicates any barriers to supervisors in an efficient and effective manner.
Perform other duties as assigned.

Education Required

Associate’s degree in nursing

Master’s degree in social work for Licensed Clinical Social Workers Education. Preferred

Bachelor’s degree in nursing

Experience

Required:

Minimum 3 years of recent care management experience with responsibilities of managing complex acute or chronic conditions in collaboration with members and interdisciplinary care professionals in a hospital, medical group or managed care setting, such as a health insurance environment and/or experience as care manager in home health or hospice environments. 

Previous care management experience to include auditing/oversight/performance management experience.

Skills

Required:

Current knowledge of clinical standards of care and disease processes, and community resources.

Excellent verbal and written communication skills; excellent interpersonal skills.

Ability to clinically analyze the most complex cases involving highly acute physical health, behavioral health, complex/catastrophic and/or psychosocial issues to determine the most effective member-centered interventions.

Proficiency in Microsoft Office MS Office applications.

Maintain confidentiality in compliance with all Health Insurance Portability and Accountability Act (HIPAA) requirements.

Ability to solve complex issues and identify creative solutions with external agencies. 

Excellent project management skills.

Working knowledge of Medi-Cal and Medicare regulations.

Preferred:

Bilingual in English/Spanish,

Licenses/Certifications Required

Licensed Clinical Social Worker (LCSW); Current and unrestricted California License or Registered Nurse (RN); current and unrestricted California License.

Licenses/Certifications Preferred

Certified Professional in Utilization Review (CPUR)

Certified Case Manager (CCM)

Pay: From $60.00 per hour

Work Location: Hybrid remote in Chico, CA 95926

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