Integrated Care Manager

Neighborhood Health Plan of Rhode Island•Smithfield, RI

About The Position

The Integrated Care Manager (ICM) works collaboratively with the integrated care team to manage and coordinate care for a specific population of members with high clinical and social risk, supporting quality, cost-effective, member-centered care. The ICM practices within the scope of licensure and uses care management principles and sound clinical judgment to coordinate services and monitor outcomes. The role includes conducting comprehensive assessments and developing care plans with members, families, primary care providers, behavioral health professionals, other health care professionals, and community agencies as appropriate. The ICM implements and regularly evaluates and revises care plans, facilitates referrals, coordinates resources, communicates with providers, and documents activities and contacts in care management software. The position also provides clinical oversight and guidance to community outreach and other team members, serves as a clinical resource to departments, and may conduct off-site visits to homes, hospitals, community health centers, or other community agencies. The position is based in Smithfield, Rhode Island, is full-time, and has a daytime shift. Daily travel is indicated.

Requirements

Active, current, unrestricted RN, LMHC, LCDP, LCSW, or LICSW license in Rhode Island in good standing. Consideration may be given to applicants without a current Rhode Island license if they provide documentation confirming an application within 24 hours of offer.
At least two years of care management, behavioral health, or community health experience.
Intermediate proficiency with PC-based software programs.
Strong organizational and interpersonal skills.
Customer service orientation.
Ability to work independently and prioritize activities.
Access to reliable transportation; if using a personal vehicle, an active driver's license and auto insurance are required.

Nice To Haves

Managed care experience.
Certified Care Manager.
Demonstrated experience working with Medicare, Medicaid, and commercial products.
Bachelor's degree.
Master's degree.
Bilingual.
Behavioral health and/or substance use expertise.

Responsibilities

Practice care management within the scope of licensure.
Use care management principles and sound clinical judgment to coordinate care for a specific member population.
Perform intensive care management for identified individuals to promote quality, cost-effective outcomes.
Conduct comprehensive assessments and develop interventions and short- and long-term goals in collaboration with members, families, providers, health care professionals, and community agencies as appropriate.
Communicate with providers to facilitate needed care.
Implement care plans, facilitate referrals, coordinate services and resources, and monitor and re-evaluate outcomes.
Continuously monitor and evaluate care outcomes and identify service gaps.
Review and revise plans of care with families and appropriate health care team members based on outcomes and evaluative findings.
Conduct off-site visits, including to homes, hospitals, community health centers, or other community agencies, as necessary or required.
Document activities and contacts comprehensively in the Care Management software system.
Collaborate with the team to identify needed services and supports.
Communicate with ancillary departments, including Provider Relations and Member Services, as needed to meet the needs of members and providers.
Meet department and regulatory standards for accuracy, proficiency, and timely documentation of decisions and plans of care.
Provide clinical oversight to community outreach and other team members, including direct supervision of community outreach staff as appropriate regarding individual care status.
Serve as a clinical resource to respond to questions from various departments.
Provide cross-coverage as assigned.
Participate in outreach and marketing activities as needed and appropriate.
Perform other duties as assigned.