SNP Case Manager is responsible for working with our dual eligible (Medicare/Medicaid) membership and completing the model of care requirements around Health Risk Assessments (HRA), High Risk Care Planning and Interdisciplinary Care Team meetings. Case Managers will make outreach to the member following our work aides and complete a HRA with the customer, create the appropriate Care Plan (CP), sending letters and documenting in Medical House of Knowledge (MHK).
Responsible for educating and motivating customers to participate in wellness programs. Support health promotion and disease prevention and care management services. Ensures that case management program objectives are met by evaluating the effectiveness of alternative care services and that cost effective, quality care is maintained. Manages own caseload and coordinates all assigned cases. The Health Risk Assessments are physical health risk assessments for a Managed Medicare Population completed by the customer with case management support.
- Excellent verbal and written communication and interpersonal skills.
- Ability to work independently and knowledge of managed care preferred.
- Ability to work with people with significant educational and or socioeconomic barriers impacting their health.
- Must have active Texas nursing License (CANNOT CONSIDER LPNs) Compact license a plus
- Ability to learn new processes and systems quickly.
- Ability to work in rapidly changing environment.
- Strong time management and organization skills.
- Ability to prioritize the work. Strong research and analytical and problem solving skills.
- Effective coaching/education skills.
Qualification & Experience:
- Experience in senior population with chronic conditions.
- Requires two to four years clinical practice experience or certification in case management with managed care and Special Needs Population (SNP) population experience at professional level.
Vacancy Type: Full Time
Job Location: Denison, TX, US
Application Deadline: N/A