Arizona Long Term Care ALTCS Case Manager

Banner Health • Oro Valley, AZ

2d • $26 - $44 • Hybrid

About The Position

Banner Plans & Networks (BPN) is an integrated network for Medicare and private health plans. Known nationally as an innovative leader, BPN insurance plans and physicians work collaboratively to keep members in optimal health while reducing costs. Supporting our members and vast network of providers is a team of professionals known for innovation, collaboration, and teamwork. If you would like to contribute to this leading-edge work, we invite you to bring your experience and skills to BPN. Arizona Long Term Care Case Managers are required to go out into the community and see members in their current setting. Member's lives in assisted living facilities, nursing homes, and their own home. Completing assessments on a 90 day or 180 schedule for each assigned member. Responsible for assessing member needs and setting up services to meet their needs. Assisting with hospital discharge planning and placements. Experience in ALTCS, Case management and Behavioral health highly desired. Schedule: Monday - Friday 8am - 5pm Must reside in Pima county. Hybrid role will be based in Pima County. Will be visiting members several times per week. Banner Plans & Networks (BPN) is an accountable care organization that joins Arizona's largest health care provider, Banner Health, and an extensive network of primary care and specialty physicians to provide the most comprehensive healthcare solutions for Maricopa County and parts of Pinal County. Through BPN, known nationally as an innovative leader in new health care models, insurance plans and physicians are coming together to work collaboratively to keep members in optimal health, while reducing costs. POSITION SUMMARY This position is responsible for assessing, documenting and monitoring the overall functional, physical and behavioral health status of members assigned to them. Based on the assessments, the case manager, collaborating with the member and his/her support system, develops a service plan that meets member needs in the most cost-effective and most integrated setting.

Requirements

• Knowledge, skills and abilities as normally obtained through the completion of a bachelor’s degree in social work, and two years of experience serving persons who are elderly and/or persons with physical disabilities or who are determined to have a Serious Mental Illness (SMI).

Nice To Haves

• Bilingual, preferred in some assignments.
• Additional related education and/or experience preferred.
• Experience in ALTCS, Case management and Behavioral health highly desired.

Responsibilities

• Is the primary contact for the ALTCS member, explaining the program to members, including their rights and responsibilities, the grievance and appeal system and other information according to regulations.
• Comprehensively assesses and documents the member’s bio psychosocial functioning in accordance with AHCCCS time frames, identifying the individual’s strengths and needs.
• Develop and implements a service plan based on the member’s strengths, needs and placement preferences, authorizes and coordinates with provider agencies.
• Assists the member to define personal goals, identifying barriers to achieving these goals and encouraging the member to resolve the difficulties identified.
• Acts as a facilitator and/or advocate for the member in dealing with issues with providers, community programs or other organizations.
• Acts as a gatekeeper to ensure that the member is receiving the most appropriate, cost-effective services in the most appropriate setting.
• Facility based while remaining within budgetary allowances.
• Internal customers: all levels of nursing management and staff, medical staff, and all other members of the interdisciplinary healthcare team.
• External customers: physicians, payers, community agencies, provider networks and regulatory agencies.

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Number of Employees: 5,001-10,000 employees