Case Manager

Southland Integrated Services, Inc.•Garden Grove, CA

46d•$29•Onsite

About The Position

Under supervision of the Program Manager, this position's primary function is to serve as an important member of the care team facilitating case management for at-risk patients and quality improvement coordination. The case manager communicates with primary care providers, referral providers, community organizations, the patient/caregiver, and family to assist with the receipt of needed services, ensure communication across the care team, reinforce adherence with the care plan and facilitate self-management skills.

Requirements

Bachelor's Degree in related health field preferred.
At least one year of medical setting experience or case management.
1 year of experience managing 50 or more cases is preferred
Experience working with the underserved and diverse populations.
Knowledge of clinic and patient protocols.
Flexible -as job duties are subject to change in order to provide the best client service available.
Ability to proceed on own initiative using independent judgment and discretion.
Possess excellent verbal and written communication skills, organizational skills, and interpersonal and time management skills.
Familiarity with electronic medical records administration.
Bi-lingual in English and Vietnamese or Spanish.
Must be able to perform comfortably in a fast-paced, deadline oriented work environment.
Strong multi-tasking skills and ability to work well in a team setting as well as independently.
Valid CA Driver's License required

Responsibilities

Develop comprehensive assessments and individualized care management plans in the areas of physical health, mental health, substance use disorders, community-based long-term services support, oral health, palliative care, social supports, and social determinants of health.
Facilitate patient appointments, including those made with labs, diagnostic areas, and specialty physicians where special assistance is needed for target population.
Coordinates with referral provider to obtain reports on labs and diagnostic tests and consultant notes as appropriate. Follow-up with patient/family if test was not done or appointment was not kept and facilitate receipt of test or provider visit.
Participate in team huddle prior to clinic session to review needed care plans and anticipate flow.
Participate in scheduled team meetings to identify care plan improvement activities.
Coordinate and collaborate with the interdisciplinary team consisting of behavioral health, dental and medical providers and other community partners for integration of care.
Facilitate the completion of depression or other risk screening instruments as appropriate.
Assist patients to determine their eligibility for appropriate government sponsored programs and refer/link to enrollment specialists as needed.
Identify gaps in care for designated patients and facilitate receipt of needed services.
Client outreach and engagement, including direct communication with clients such as in person meetings, mail, email, texts and telephone; community and street-level outreach
Adhere to established productivity benchmarks.
Provide outreach, education, referrals/linkages to the homeless and at-risk populations.
Perform other duties as assigned.