Provides case management services independently for a caseload ranging in complexity
from basic to complex; acuity levels 1-4; performs field-based case management (acuity
level 5) with supervision.
- Initiates and coordinates individualized care plan for assigned members, addressing both
clinical and non-clinical components, and ensuring the care plan is available
to both the member and primary care provider.
- Resolves member needs by utilizing multidisciplinary team strategies, including Health
Services Integrated Rounds Meetings.
- Ensures a smooth implementation and continuum of care via effective and frequent
communication with providers, members, and identified health care designee.
- Communicates clearly and effectively through all mediums of communication with
members, providers, vendors, community partners, and Partnership employees.
- Coordinates referrals and authorizations for services required to improve the
member’s health status.
- Maintains accurate and timely documentation, records, and case files in the Partnership
- Case Management System for members in case management.
- Applies evidence-based interventions based upon member’s agreed upon goals/
- priorities
- Develops and maintains knowledge of a community based network of alternative
modes of care; aids member to connect with community-based organizations to support
and enhance wellness.
- Answers and triages department calls, and distributes department referrals with
guidance, in accordance with identified department service levels.
- Collaborates and coordinates with other internal departments to identify members
suitable for case management.
- Actively participates in essential skills training, unit and departmental assigned learning,
and other departmental activities as assigned.
- Functions collaboratively in a team environment, including acting as a support and
resource to other staff.
- Coordinates and participates in meetings with Partnership providers, as assigned.
