CCT/Home Case Manager (2132)

Andwell Health Partners•Lewiston, ME

19d

About The Position

At Andwell, you don’t just work here, you belong. Being a part of the team at Andwell Health Partners means belonging to a community of people with purpose, dedicated to enhancing the quality of life of those we serve by providing innovative and compassionate health care in the comfort of their homes and communities. Take control of your day with flexible scheduling options. Ability to utilize and challenge your skills in the home or community setting. More 1:1 time with patients, working autonomously in the comfort of their home. Comprehensive benefit package to support life outside of work. Stability – An employer of choice for 50 years. Centralized HR, IT, education, and employee experience departments for improved support. What You’ll Do: Care Manager Social Worker will, in collaboration with the primary care practice, coordinate services using a systematic and cost-effective approach to provide patient-centered care for a defined population. The Care Manager will engage the patient to reduce unnecessary health care services and improve their overall health and well-being. A specialized focus on housing support will be provided to HOME enrolled patients. Care Manager to work with each practice to assess the gaps in care coordination as well as patients’ access to and utilization of community supports. The Care manager will need to collaborate with designated physician practices and community partners to determine the best model for addressing the needs of the most complex patients. Work with patients with complex emotional-social issues and mental health concerns. Work with CCT, primary care provider, and MaineCare to identify recipients who are most likely to benefit from care management intervention and agree to participate. Care manager may make patient visits prior to hospital discharge, in the primary care practice, in the home or public setting.

Requirements

One or More of the following certifications: Maine Community Health Worker, MHRT-c, Current Social Worker licensure (preferred)or conditional Social Work licensure in the State of Maine.
Must have a reliable automobile.
Must have current Maine driver’s license.
Evidence of automobile insurance.
Annual flu vaccination required.

Responsibilities

coordinate services using a systematic and cost-effective approach to provide patient-centered care for a defined population
engage the patient to reduce unnecessary health care services and improve their overall health and well-being
assess the gaps in care coordination as well as patients’ access to and utilization of community supports
collaborate with designated physician practices and community partners to determine the best model for addressing the needs of the most complex patients
Work with patients with complex emotional-social issues and mental health concerns
Work with CCT, primary care provider, and MaineCare to identify recipients who are most likely to benefit from care management intervention and agree to participate
make patient visits prior to hospital discharge, in the primary care practice, in the home or public setting