Case Manager II

LifeLong Medical Care•Oakland, CA

13h•$24 - $32

About The Position

The Case Manager II (CM II), a key member of the primary care interdisciplinary team, provides services for patients with complex care needs. This position conducts patient outreach, engagement and psychosocial service assessment, assists in developing a patient-centered care plan, is the lead implementer of Enhanced Case Management (ECM) and coordinates service referrals and delivery. The Case Manager meets clients in home, clinic, or community as appropriate or required by the specific program/site. The CM II provides services to specific populations that have multiple complex health and social services needs and often provides care outside of a traditional health center setting, such as home visits, hospitals, supportive housing sites, encampments and shelters. This is a full time, grant funded, benefit eligible position at our Brookside San Pablo Health Center. This position is represented by SEIU-UHW. Salaries and benefits are set by a collective bargaining agreement (CBA), and an employee in this position must remain a member in good standing of SEIU-UHW, as defined in the CBA.

Requirements

High School diploma or GED
At least two (2) years of progressively responsible work or volunteer experience in a community-based health care or social work setting or at least one (1) year of experience as a Case Manager I or equivalent position
Proficient skills using Microsoft Office applications like Word, Excel, and Outlook, as well as the ability to work in and/or manage databases
Access to reliable transportation with current license and insurance
Bilingual/Spanish
Commitment to working directly with low-income persons from diverse backgrounds in a culturally responsive manner
Commitment to harm reduction, recovery, housing first, age-friendly and patient centered care
Strong organizational, administrative and problem-solving skills, and ability to be flexible and adaptive to change while maintaining a positive attitude
Excellent interpersonal, verbal, and written skills
Ability to prioritize tasks, work under pressure, and complete assignments in a timely manner
Ability to seek direction/approval on essential matters, yet work independently, using professional judgment and diplomacy
Works well in a team-oriented environment
Conducts oneself in external settings in a way that reflects positively on your employer
Ability to be creative, mature, proactive, and committed to continual learning and improvement in professional settings

Nice To Haves

Bachelor’s Degree in Social Work, Health or Human Services field
Lived experience of homelessness, incarceration, foster care, mental health services, substance use services or addiction, or as a close family member of someone who has this experience

Responsibilities

Outreach, via telephone and in person at LifeLong, community and residential sites, to patients who meet case management program eligibility criteria or are prioritized by LifeLong for this service
Proactively meet and engage with patients to build effective relationships and assess strengths and needs through use of standard intake, screening tools, and health, and social services records review
Actively involve patients and caregivers, as appropriate, in designing and delivering services, including development of care plans, assuring alignment with patients’ values and expressed goals of care
Provide and facilitate referrals for internal and external resources, and collaborate with the patient to complete required applications, forms, or releases of information
Maintain a patient caseload in accordance with LifeLong standards for the specific population served or site requirements
Utilize data registries and reports to manage caseload, meet program requirements, maintain grant deliverables, and promote high quality care
Provide health education and training to patients, including but not limited to, harm reduction and disease risk-mitigation strategies that empower patients to manage their own health and wellness (e.g. overdose prevention, mitigating spread of communicable diseases)
Assist patients with accessing and retaining public benefits and insurance (e.g. MediCal, SSI/SSDI, CalFresh, General Assistance), and affordable/subsidized housing
Respectfully and routinely communicate with patients, their care team members, external partners, and identified social supports
Maintain knowledge of patients’ medical/behavioral health treatment plans and facilitate utilization of services by providing resources such as accompaniment, transportation, in-home care, reminder calls etc.
Participate in team meetings to coordinate care, support patient goals, and reducing barriers to accessing services
Advocate on behalf of patients to get their needs met and/or support patients to learn advocacy strategies for themselves.
Provide case management services to patients with multiple complex acute or chronic medical or behavioral health conditions (e.g. HIV/AIDS, Hep C, congestive heart failure, severe diabetes, severe hypertension, psychosis, pregnancy, and homelessness)
Provide general housing case management services that includes document readiness, housing problem solving, and assessments for Coordinated Entry System
Assist with patient crisis intervention and de-escalation
Provide and document billable services to eligible populations that result in revenue generation for LifeLong
Keep current on community resources and social service supports to effectively serve the target population
Document patient contacts/services in required data systems (EHR, HMIS etc.) according to LifeLong policy
Specific activities may vary depending on the requirements of the program and funder.
Promote diversity, equity, inclusion, and belonging in support of patients and staff
Represent LifeLong positively in the community and advocate on behalf of underserved populations