Performs advanced case management and intervention for high risk members of the Tuality Health Alliance by using a collaborative process which assesses, plans, implements, coordinates, monitors and evaluates the options and services to meet an individual's health needs using communication and available resources to promote quality and, cost effective outcomes.
Collect and assess member information pertinent to members history, condition, and functional abilities in order to develop a comprehensive, individualized care plan that promotes wellness, appropriate utilization, and cost - effective care and services.
Performs evaluation in multiple environments including process and relationships, health care management, community resource and support, service delivery, psychosocial intervention and rehabilitation.
Provide care coordination and management services for members with identified needs: Creatively using available and appropriate resources, including KP staff and providers, to support the unique needs of each member; Facilitating access to internal and external services.
Manage the quality and productivity of tasks and workflow as they relate to both assigned functions and the overall effectiveness of the Health Services team. Work to resolve issues and improve processes and outcomes.
Serve as liaison with other PacificSource departments or community partners to coordinate optimal provision of service and information. Serve on various internal and external committees as required or designated. Document and report any pertinent communications back to the team or department.