Job Information
Community Health Plan of Washington Case Manager I (Medical MSW or RN) - Medicare/DSNP in Seattle, Washington
Working Each Day to Make a Difference
At Community Health Plan of Washington, we're driven by our belief that everyone deserves access to quality health care.
More than 25 years ago, we made a commitment to improve the health of our communities by making quality health care accessible to all Washington state residents.
We continue that pledge today by providing affordable comprehensive coverage to more than 315,000 individuals and families throughout the state.
- We are a local not-for-profit health plan in Washington State.
- We are committed to keeping Washington families healthy.
- We connect our communities to the health resources they need.
- We provide access to high-quality care for our members.
- We connect and empower our members through technology.
- The Community Health Centers we partner with strive to support members with a comprehensive mix of medical resources in one convenient location.
- Our partnerships with Community Health Centers and our extended provider network help us improve the health care delivery system.
To learn more about how you can make a difference working at Community Health Plan of Washington, visitwww.chpw.org{rel="nofollow"}.
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Case Manager I (Medical MSW or RN) - Medicare/DSNP This position is fully remote. We are targeting an individual who live in the Chelan County region and is knowledgeable of the area and its available resources. This is essential in being able to assist our Medicare and Dual Plan members by providing education coordination with care teams and connecting to community-based resources. We are looking to consider any qualified candidates in western Washington State.
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[POSITION PURPOSE:]{.underline}
Responsible for the operational delivery of the plan's case management and coordination programs and processes. Provides case management services for CHPW members with short term, long term, stable, unstable, and predictable course of illness, and/or highly complex medical/behavioral and social conditions. The goal is to improve members' quality of life and ensure cost-effective outcomes by using internal and community-based resources.
[PRINCIPAL DUTIES:]{.underline}
The Case Manager I is responsible for performing telephonic case management for members with acute, chronic, and complex needs. Examples listed below are not necessarily exhaustive and may be revised by the employer.
Advocates on behalf of members and facilitates coordination of resources required to help members reach optimum functional levels and autonomy within the constraints of their disease conditions.
Works within a multi-functional team to connect with providers, members, caregivers, contracted vendors, community resources, and health plan partners to assess the member's health status, identify care needs and ensure access to appropriate services to achieve positive health outcomes.
Assesses, evaluates, plans, implements, and documents care of members within the organization's clinical database system, in accordance with organizational policies and procedures.
Responsible for the assessment of members, including identifying and coordinating access to the appropriate level of care and treatment. Uses the assessment information to assign the appropriate risk and complexity level and create and document a care plan in coordination with the member, family and health team input.
Initiates a plan of care based on member-specific needs, assessment data and the medical/behavioral plan of care. Goals for members are measurable and developed in conjunction with the patient/family to improve quality of life.
Plans care in collaboration with members of the multidisciplinary