Position in this function supports corporate objectives by utilizing the demonstrated competency of Long Term Services and Supports to provide Case Management services. Will participate in case conferences with the Supervisor.
If you are located in Colorado and locally to Alamosa, Rio Grande, Costilla, Conejos or Saguache County , CO, you will have the flexibility to work remotely* as you take on some tough challenges.
Primary Responsibilities: - Intake/screening/referral, assessment/reassessment, development of support plans, on-going case management, monitoring of the Member's health and welfare, documentation of contacts and case management activities in the Department-prescribed system, resource development, and case closure
- Respect confidentiality and maintain confidence as described in the UHG Employee Handbook and acknowledged through signature by all employees. Maintain confidentiality of patient information. The ability to maintain confidentiality is a critical and essential component of this position
- Conduct monitoring contacts as prescribed by the Department. Contact the Member at least once within each quarterly period or more frequently as warranted by the Member's condition /or as determined by the rules of the LTSS Program in which the Member is enrolled
- Conduct face-to-face contact with the Member's at least every six months or more frequently if warranted by the Member's condition or the rules of the LTSS Program in which the Member is enrolled. Update the current approved assessment tool and care or support plan in the appropriate documentation system(s) to reflect any changes in condition or services
- Complete a new assessment during a face-to-face reassessment annually or more frequently if warranted by the Member's condition or if required by the rules of the LTSS Program in which the Member is enrolled. Complete additional assessments as needed/required
- Monitor the delivery of services and supports identified within the Support Plan and the Prior Authorization Request (PAR)
- Attend Department provided training for CMA agencies as well as agency provided in-service and staff development training
- Responsible to conduct Work that is in accordance with the CMA Contract Agreement's requirements. This includes but is not limited to, providing Work that is accurate, timely, and complete
- In the event, at any time throughout the case management process, the case manager suspects an individual to be a victim of mistreatment, abuse, neglect, exploitation or a harmful act, the case manager shall immediately refer the individual to the protective services section of the county department of social services of the individual's county of residence and/or the local law enforcement agency
- May take on special assignments and projects on an as needed basis. Assist with system assessment and development as needed
- This position requires travel. Requires independent, reliable, flexible, and on-demand, transportation at the incumbent's expense for travel between various locations and timely arrival and departure from various locations. If the employee chooses to satisfy this requirement by driving a vehicle, the employee must meet the requirements for Colorado licensure and company requirements for liability insurance coverage
- This function is for UHC C&S Only (with the exception of the Community Health Worker role). Positions in this function address efforts focused on medical, behavioral, and social determinants of health factors that improve the well-being of individuals, families, and communities
You'll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in.
Required Qualifications: - Must meet one of the following:
- Bachelor's degree in one of the human behavioral science fields such as human services nursing, social work, psychology, public health
- 5+ years of relevant experience in the field of LTSS
- A combination of education and LTSS experience
- 1+ years of experience with MS Office, including Word, Excel, and Outlook
- Reliable transportation and the ability to travel up to 50% within assigned territory to meet with members and providers
- Reside locally to Alamosa, Rio Grande, Costilla, Conejos and Saguache Counties
Preferred Qualification:- Experience as a caseworker or case manager with LTSS population, in a private or public social services agency may substitute for the required education on a year for year basis
Physical Requirements:- Ability to transition from office to field locations multiple times per day
- Ability to navigate multiple locations/terrains to visit employees, members and/or providers
- Ability to transport equipment to and from field locations needed for visits (ex. Laptop)
Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with us, you'll find a far-reaching choice of benefits and incentives. The hourly pay for this role will range from $29 - $52 per hour based on full-time employment. We comply with all minimum wage laws as applicable.
Application Deadline: This will be posted for a minimum of 2 business days or until a sufficient candidate pool has been collected. Job posting may come down early due to volume of applicants.
