Care Manager (Door and Kewaunee) (Home-Based with Field Travel)

Lakeland Care Incorporated•Town of Ledgeview, WI

13h•Hybrid

About The Position

Join our award winning culture as we serve members in your area! The Care Manager, as part of an interdisciplinary team (IDT), serves frail elders, adults with physical disabilities and adults with intellectual/developmental disabilities who are members of Lakeland Care (LCI). The team’s goal is to promote the overall well-being of the members LCI serves by providing high quality, person-centered, outcome-based care. Under general direction of the Care Management Supervisor, this position provides care management and service coordination to LCI members. As a member of the IDT, the Care Manager arranges for provision of services and supports based on a comprehensive assessment of the member's identified outcomes and needs. The IDT monitors the provision of services based on the member-centered plan per LCI policy and procedures, and Department of Health Services (DHS) contract requirements. As part of an interdisciplinary team (which also includes an RN Care Manager and the member and/or legal representative), the Care Manager will conduct a comprehensive assessment of the member's outcomes, needs and risks; and conduct a reassessment as the member’s outcomes and/or condition changes. They will collaborate with the RNCM to coordinate acute and primary care services, care transitions, and related follow-up care. The role involves developing, coordinating, monitoring and evaluating the members’ outcome-based member-centered plans, considering cost and effectiveness in authorizing services and choosing providers. The Care Manager coordinates care and benefits to ensure a comprehensive support approach, as well as on-going access to federal and state programs. They implement risk mitigation strategies to promote the member’s health, safety and independence while respecting the member’s rights. The position also educates members of their rights to appeal and grieve decisions and processes and facilitates the member's participation in the appeal/grievance process. Ongoing training and maintaining current knowledge to ensure compliance with Federal and State regulations, LCI policy and procedure and accepted professional standards are also part of the role. The Care Manager creates and maintains member records as required by the Department of Health Services (DHS) contract and LCI policy. They coordinate and participate in home visits and care conferences involving the member, their supports, and providers to assess and reassess long-term care needs and coordinate appropriate interventions. Participation in the 24-hour on-call rotation as needed and in team meetings and internal workgroups as required/requested is also expected. Maintaining the confidentiality of member information and protected health information (PHI) as required by State and Federal regulations, including the Health Insurance Portability and Accountability Act (HIPAA) of 1996 is crucial.

Requirements

Certified Social Worker in the State of Wisconsin with a minimum of one (1) year experience working with at least one of the Family Care target populations, or
A four-year bachelor’s degree or more advanced degree in Human Services or related field with one (1) year experience working with at least one of the family care populations, or
A four-year bachelor’s degree or more advanced degree in any other area than Human Services with a minimum of three (3) years’ experience working with at least one of the Family Care target populations.
Working knowledge of computers, computer programs, typing, and data entry.
Ability to access members’ homes which are not required to comply with the ADA regulations.
Ability to multi-task and work in a fast-paced environment.
Ability to lift up to 25lbs.
Current driver’s license, acceptable driving record and proof of adequate insurance.

Responsibilities

As part of an interdisciplinary team (which also includes an RN Care Manager and the member and/or legal representative), conduct a comprehensive assessment of the member's outcomes, needs and risks; and conduct a reassessment as the member’s outcomes and/or condition changes.
Collaborate with the RNCM to coordinate acute and primary care services, care transitions, and related follow-up care.
Develop, coordinate, monitor and evaluate the members’ outcome-based member-centered plans, considering cost and effectiveness in authorizing services and choosing providers.
Coordinate care and benefits to ensure a comprehensive support approach, as well as on-going access to federal and state programs.
Implement risk mitigation strategies to promote the member’s health, safety and independence while respecting the member’s rights.
Educate members of their rights to appeal and grieve decisions and processes and facilitate the member's participation in the appeal/grievance process.
Participate in on-going training; maintain current knowledge to ensure compliance with Federal and State regulations, LCI policy and procedure and accepted professional standards.
Create and maintain member records as required by the Department of Health Services (DHS) contract and LCI policy.
Coordinate and participate in home visits and care conferences involving the member, their supports, and providers to assess and reassess long-term care needs and coordinate appropriate interventions.
Participate in the 24-hour on-call rotation as needed.
Participate in team meetings and internal workgroups as required/requested.
Maintain the confidentiality of member information and protected health information (PHI) as required by State and Federal regulations, including the Health Insurance Portability and Accountability Act (HIPAA) of 1996.