Care Manager

Sourced Hire•Lakeland, FL

11d

About The Position

Opportunity to work in a dynamic, fast-paced, and innovative care management company that is transforming the delivery of kidney care. Competitive compensation package. Flexible paid leave and vacation policy. This is a full-time position in Home Health with frequent travel Laptop, mileage reimbursement, phone allowance, and extra perks are available! This position works within a 2-hour travel radius. Rare domestic travel may be required to Nashville, TN The work schedule is Monday Friday 8 am 5 pm. However, there could be exceptions where a patient does request a visit after 5 pm. Pay is Based on Years of experience.

Requirements

Masters Degree in Social Work, behavioral sciences, or another related field.
Currently licensed as an LCSW or LMSW in the State of MA
2+ years of previous experience working in care management and/or with chronic illness within a medical environment in home health or hospice.
Ability to take calls remotely on some nights and weekends.
Self-starter with the ability to work independently with minimal supervision.

Responsibilities

Ability to show empathy and quickly build relationships with patients and local CBOs
Perform in-home care management visits to assess and impact the social and behavioral status
Work closely with Care Team to ensure continual progress on all care management goals
Assess social determinants of health needs and develop a plan for addressing them
Perform behavioral, environmental, and social support assessments and surveys as needed
Deliver individual, family, and group education on living with chronic illness
Engage family and social support groups in the education and care of patients
Assess patients and refer them to behavioral health specialists if diagnosis and treatment needed
Help patients understand, accept and follow medical and lifestyle recommendations
Serve as the point of contact for patient questions regarding social and behavioral
Facilitate conversations around and consideration of proactive care decisions, especially relating to transplantation, home modalities, and AV fistula placement
Initiate patient relationships through enrollment and onboarding processes
Review and document patient updates and progress in the care management platform
Identify, vet, and build relationships with local Community-Based Organizations
Introduce patients to appropriate resources and act as the patient advocate
Serve as subject matter expert on social determinants for other members of the Care Team