Care Manager (RN/LICSW)

Enlightened, Inc.•Washington, DC

6h•Onsite

About The Position

The Care Manager (RN/LICSW) is responsible for engaging with enrollees, their caregivers, and providers to assess needs, develop care plans, and establish individualized goals. This role supports enrollees who are appropriate for care coordination and case management services, helping them achieve their optimal level of health and overall well-being. This individual will support the Complex Care Management program by providing comprehensive, person-centered care management services to enrollees across the lifespan who are living with complex medical needs.

Requirements

Qualified candidates must reside in the DC Metro area (District of Columbia residents strongly preferred).
Active DC RN or current unrestricted LICSW license.
3 to 5 years of nursing/social work experience required, including working with Medicaid populations in hospital or community health settings.
3 to 5 years of experience working with adult and/or pediatric populations with complex medical and behavioral health needs required.
Willingness to meet face-to-face with enrollees in the community based on business needs.

Nice To Haves

Bachelor's degree or higher in a health-related field preferred
Case manager certification preferred (as documented and accepted on URAC’s website at www.urac.org [http://www.urac.org/]).
3 to 5 years of case management experience preferred.
Bilingual English/Spanish or English/Amharic preferred.

Responsibilities

Assess enrollees to determine care coordination and case management needs for all referred enrollees.
Complete comprehensive person-centered assessments covering physical health, psychosocial health, environmental factors, social determinants of health, and supportive needs.
Identify problems and barriers to care coordination and implement appropriate care management interventions.
Coordinate physical, behavioral health, and social services.
Provide medication management, including regular reconciliation and support for medication adherence.
Develop care plans to help enrollees reduce or resolve problems and barriers, enabling them to achieve optimal health.
Establish short- and long-term goals with associated time frames, sharing these goals with enrollees and caregivers as appropriate.
Identify and implement appropriate interventions based on enrollee needs and clinical progress.
Schedule follow-up calls as necessary, make referrals, and take action to address enrollee issues. Document progress toward goals and problem resolution.
Coordinate care and services with Care Coordinators, Community Health Navigators, enrollees, caregivers, Primary Care Physicians (PCPs), specialists, and facility/vendor providers.