Care Manager

<p><span id="job_summary" class="summary">We are looking for the best and the brightest problem-solvers who are dedicated to changing the way health care is delivered and are passionate about creating a better model for our national health care system. We offer a professional working environment, competitive salaries and excellent benefits. As we continue to grow, we are seeking an experienced Care Manger to join our Detroit, Michigan, office. <br /></span></p>

Corporate Office in Detroit, MI

Healthcare Company

Our task is to make sure that you and your eligible family members are enrolled and receiving Medicaid or Alliance Benefits. Our mission is to help our D.C. neighbors receive the care and services needed to lead a long and healthy life.

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Competitive Salary & Benefits

Overview: <p>The Care Manager will manage the member population with education, health advocacy and the connections to the resources they need.&nbsp; This role provides comprehensive case management, and coordination of care for THP members, operating with emphasis in designated clinical areas.</p>
Responsibilities: <ul> <li>Contacts patient to assess the patient's condition, understanding of his/her injury and the patient's ability to follow the treatment plan.</li> <li>Contacts members of the medical team to discuss the patient's course of progress and needs utilizing available discharge information (if there was a hospitalization) and the initial needs assessment.</li> <li>Arranges for all services required coordinating services with the health care team to eliminate duplication of service and conserve health benefit dollars.</li> <li>Contacts or visits family to ascertain its understanding of the patient's diagnosis and prognosis and it ability to provide caregiver support.</li> <li>Checks home for safety factors and architectural barriers and arrange for any modifications.</li> <li>Identifies problems, anticipates complications and acts to avoid them, providing health instruction to the patient and family and referring the patient back to the physician or other health care team members when appropriate.</li> <li>Identifies plateaus, improvements, regressions and depressions; counseling accordingly and recommending help.</li> <li>Makes personal visits or contacts the physician to clarify diagnosis, prognosis, therapies, activities of daily living, etc.</li> <li>Provides authorizations for any modalities of treatment recommended; investigation and suggesting alternative treatments when appropriate.</li> <li>Assists with obtaining information and forms regarding living wills, health care proxy, do-not-resuscitate order, etc.</li> <li>Documents case summary based on information received and communicates with the beneficiaries and involved providers.</li> <li>Conducts personal visits to the patient's home or hospital.</li> <li>Educates physicians and appropriate personnel regarding benefits and limitations as well as payment processes.</li> <li>Collaborates with the physicians, beneficiaries/families, and involved providers to evaluate the beneficiary needs and ensure beneficiaries are receiving adequate services to meet their needs.</li> <li>Reports to the Director of CM/DM/HE</li> </ul>
Requirements: <ul> <li>Active Michigan RN License or Clinical Social Worker license preferred.</li> <li>Certification in Case Management preferred.</li> <li>Bachelor&rsquo;s Degree in related Health/Nursing field preferred.</li> <li>A minimum of two years of experience in health care, case management, care coordination, discharge planning or utilization management. </li> </ul>