Job Responsibilities : Care Manager
Salary : $16 per hour
Company : Lakeland Care, Inc.
Location : Remote
Principal Duties and Responsibilities:
The following duties are typical for this position. These are not to be construed as exclusive or all-inclusive. Other duties may be required and assigned.
As part of an interdisciplinary team (which also includes a RN Care Manager and the member and/or legal representative) conduct a comprehensive assessment of the member’s outcomes needs and risks; and conduct a reassessment as the member?s outcomes and/or condition changes.
Develop coordinate monitor and evaluate the members? outcome-based member-centered plans considering cost and effectiveness in authorizing services and choosing providers.
Implement risk mitigation strategies to promote the member?s health safety and independence while respecting the member?s rights.
Coordinate and participate in home visits and care conferences involving the member their supports and providers to assess and reassess long-term care needs and coordinate appropriate interventions.
Collaborate with the RNCM to coordinate acute and primary care services care transitions and related follow-up care.
Coordinate care and benefits to ensure a comprehensive support approach as well as on-going access to federal and state programs.
Create and maintain member records as required by the Department of Health Services (DHS) contract and LC policy.
Educate members of their rights to appeal and grieve decisions and processes and facilitate the member’s participation in the appeal/grievance process.
Current knowledge to ensure compliance with Federal and State regulations LCI policy and procedure and accepted professional standards.
Maintain the confidentiality of member information and protected health information (PHI) as required by State and Federal regulations including the Health Insurance Portability and Accountability Act (HIPAA) of 1996.