About the Role:

• Client is seeking a dedicated Case Manager to work with members, providers, and multidisciplinary team members to assess, plan, and coordinate integrated care delivery for members with high need potential.
• The Case Manager will ensure that patients receive quality, cost-effective care that is medically appropriate based on the severity of illness and site of service.

Responsibilities: -

• Complete face-to-face comprehensive assessments of members within regulated timelines.
• Facilitate comprehensive waiver enrollment and disenrollment processes.
• Develop and implement case management plans in collaboration with members, caregivers, physicians, and other healthcare professionals. 
• Monitor care plans, evaluate effectiveness, document interventions, and suggest changes as needed.
• Promote integration of services for members, including behavioral health care and long-term services and supports.
• Assess medical necessity and authorize appropriate waiver services.
• Conduct home visits and interdisciplinary care team meetings.
• Use motivational interviewing techniques to educate and support members.
• Identify barriers to care and provide assistance to address obstacles.
• Develop prevention plans for critical incidents to ensure member health and welfare.
• Requires 50-75% local travel.

Education Qualification: -

• Completion of an accredited Licensed Vocational Nurse (LVN) or Licensed Practical Nurse (LPN) Program OR Bachelor's or master’s degree in a related field OR equivalent combination of education and experience.

Required Skills: -

• At least 1 year of experience working with persons with disabilities/chronic conditions and Long Term Services & Supports.
• 1-3 years of experience in case management, disease management, managed care, or medical/behavioral health settings.
• Active and unrestricted Certified Case Manager (CCM) preferred.
• Active, unrestricted State Nursing license (LVN/LPN) OR Clinical Social Worker license. 
• Valid driver’s license with good driving record and reliable transportation.