CARE COORDINATOR/CAREGIVER/LCM
Company: BLEHEALTH, LLC
Location: Pomona
Posted on: March 13, 2023
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Job Description:
BLEHEALTH, LLC - The Care Coordinator/Lead Care Manager works in
collaboration and continuous partnership with chronically ill or
"high-risk" members and their family/caregiver(s),
clinic/hospital/specialty providers and staff, and community
resources in a team approach to:
- - - - - - - Coordinate with those individuals and/or entities to
ensure a seamless experience for the member and non-duplication of
services.
- - - - - - - Engage eligible members.
- - - - - - - Oversee provision of ECM services and implementation
of the care plan.
- - - - - - - Offer services where the member lives, seeks care, or
finds most easily accessible and within the Plan guidelines.
- - - - - - - Connect member to other social services and supports
the member may need, including transportation.
- - - - - - - Advocate on behalf of members with health care
professionals.
- - - - - - - Use motivational interviewing, trauma-informed care,
and harm-reduction approaches.
- - - - - - - Coordinate with hospital staff on discharge
plans.
- - - - - - - Accompany member to office visits, as needed and
according to the Plan guidelines.
- - - - - - - Monitor treatment adherence (including
medication).
- - - - - - - Provide health promotion and self-management
training
- - - - - - - Promote timely access to appropriate care
- - - - - - - Increase utilization of preventative care
- - - - - - - Reduce emergency room utilization and hospital
readmissions
- - - - - - - Increase comprehension through culturally and
linguistically appropriate education
- - - - - - - Create and promote adherence to a care plan,
developed in coordination with the member, primary care provider,
and family/caregiver(s)
- - - - - - - Increase continuity of care by managing relationships
with tertiary care providers, transitions-in-care, and
referrals
- - - - - - - Increase members' ability for self-management and
shared decision-making
- - - - - - - Connect members to relevant community resources to
enhance member health and well-being, increase member satisfaction,
and reduce health care costs.
- - - - - - - Connect and follow up with members,
family/caregiver(s), providers, and community resources via
face-to-face, secure email, phone calls, text messages, and other
communications.
- - - - - - - Serve as the contact point, advocate, and
informational resource for members, care team, family/caregiver(s),
payers, and community resources
- - - - - - - Work with members to plan and monitor care
- - - - - - - Assess member's unmet health and social needs
- - - - - - - Develop a care plan with the member,
family/caregiver(s), and providers (emergency plan, health
management plan, medical summary, and ongoing action plan, as
appropriate)
- - - - - - - Monitor adherence to care plans, evaluate
effectiveness, monitor member progress on time, and facilitate
changes as needed
- - - - - - - Create ongoing processes for members and
family/caregiver(s) to determine and request the level of care
coordination support they desire at any given time.
- - - - - - - Facilitate member access to appropriate medical and
specialty providers
- - - - - - - Educate members and family/caregiver(s) about
relevant community resources
- - - - - - - Facilitate and attend meetings between members,
family/caregiver(s), care team, payers, and community resources, as
needed
- - - - - - - Cultivate and support primary care and specialty
provider co-management with timely communication, inquiry,
follow-up, and integration of information into the care plan
regarding transitions-in-care and referrals
- - - - - - - Assist with the identification of "high-risk" members
(the chronically ill and those with special health care needs), and
add these to the member registry (or flag in EHR)
- - - - - - - Attend all Lead Care Manager training
courses/webinars and meetings
- - - - - - - Provide feedback for the improvement of the ECM
Program
- - - - - - - Offer services where the Member lives, seeks care, or
finds most easily accessible and within Medi-Cal Managed Care
health plans (MCP) guidelines
- - - - - - - Engage eligible Members
- - - - - - - Arrange transportation
- - - - - - - Call Member to facilitate Member visit with the ECM
Lead Care Manager -
QUALIFICATION REQUIREMENTS:
To perform this job successfully, an individual must be able to
perform each essential duty satisfactorily. The requirements below
represent the required knowledge, skill, and/or ability. Reasonable
accommodations may enable individuals with disabilities to perform
essential functions.
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EDUCATION AND/OR EXPERIENCE: -
- - - - -High school Diploma, Paraprofessional (with appropriate
training) -
- - - - - - - Evidence of essential communication, education, and
counseling skills
- - - - - - - Proficiency in communication technologies (email,
cell phone, etc.)
- - - - - - - Highly organized with the ability to keep accurate
notes and records
- - - - - - - Experience with health IT systems and reports is
desirable
- - - - - - - local knowledge about and connections to community
health care and
- - - - - - - social welfare resources are desirable
- - - - - - - Ability to speak a relevant second language is
desirable
SKILL AND KNOWLEDGE REQUIREMENTS:
Excellent analytical, problem-solving, and prioritization
skills.
Use statistical and graphic displays.
Excellent verbal and written communication skills.
High-level interpersonal skills. Able to work collaboratively and
tactfully with multi-disciplinary and diverse teams that may
include employees, customers, and physicians.
Effective computer skills, particularly Microsoft Office, Excel,
PowerPoint, Publisher, Paint, Word, etc.
Work independently to complete assigned tasks.
Team building
Project Management
Change Management
Quality and Process improvement tools
Project Execution
Keywords: BLEHEALTH, LLC, Pomona , CARE COORDINATOR/CAREGIVER/LCM, Healthcare , Pomona, California
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