Reentry Targeted Case Manager

MEDIKO INC•Des Moines, WA

1d•Onsite

About The Position

The Reentry Targeted Case Manager (rTCM) provides person-centered, recovery-focused care coordination to justice-involved Apple Health (Medicaid) clients during the pre-release period. This role supports individuals as they transition from incarceration to the community by completing reentry assessments, developing care plans, coordinating medical and behavioral health services, and connecting clients to needed community resources. The rTCM ensures all required components of the Washington Apple Health rTCM model are delivered according to state regulations, documentation requirements necessary to support Medicaid billing, and facility standards. The rTCM collaborates closely with clinical teams, behavioral health providers, community partners, and Medicaid Managed Care Organizations to support continuity of care and reduce gaps in service during reentry.

Requirements

Active licensure that permits assessment and care-planning across medical and behavioral health needs (e.g., Registered Nurse).
Must meet provider enrollment requirements under Chapter 182-502 WAC, including NPI eligibility and Medicaid/ProviderOne enrollment (or ability to enroll upon hire).
Bachelor’s degree in a relevant field (e.g., Human Resources, Finance, Sales, Business Administration, Healthcare Administration, or related discipline) from an accredited institution preferred.
Minimum of 2-3 years of relevant experience in the specific functional area (e.g., HR, Finance, Sales, Marketing, Operations, etc.).
Experience in healthcare, correctional healthcare, or a regulated industry is preferred.
Demonstrated success in applying function-specific skills (e.g., employee relations for HR, financial reporting for Finance, or sales strategy for Sales) is required.
Knowledge of relevant industry-specific regulations, compliance standards, and best practices may be required, particularly for roles in highly regulated functions like HR and Finance.
Active CPR/BLS certificate required (American Heart Association/American Red Cross guideline approved), if role is located in a correctional facility.

Nice To Haves

Additional certifications or specialized training may be required depending on the function (e.g., Certified Human Resources Professional (PHR) for HR roles, Certified Public Accountant (CPA) for Finance roles, etc.).
Relevant industry certifications based on the role (e.g., PHR, SHRM-CP, CPA, etc.).

Responsibilities

Conduct comprehensive, person-centered reentry assessments that evaluate medical, behavioral health, substance use, and social support needs.
Develop individualized reentry care plans in collaboration with the client, outlining goals, referrals, medications, follow-up appointments, and community supports.
Maintain clinical documentation in accordance with Medicaid, state, and facility requirements.
Update care plans based on client needs, progress, or changes in health status.
Coordinate warm hand-offs to community providers, including primary care, behavioral health, MAT/SUD programs, and social service agencies.
Assist clients in reconnecting or enrolling with Medicaid Managed Care Organizations and Apple Health benefits as needed.
Ensure release medications, appointments, and community placements are aligned with the client’s reentry plan.
Provide education on medication adherence, chronic disease management, mental health follow-up, and community-based services.
Work closely with internal nursing, behavioral health, mental health, and administrative teams to ensure coordinated service delivery.
Communicate with external providers, caseworkers, Medicaid MCOs, peer support organizations, and community agencies to arrange services prior to release.
Participate in interdisciplinary meetings, case reviews, and care coordination huddles.
Build strong working relationships with correctional facility staff to ensure operational alignment and continuity.
Document all rTCM activities in the EMR and required Medicaid systems in accordance with state regulations and documentation requirements necessary to support Medicaid billing.
Ensure compliance with all elements of the Reentry Targeted Case Management model, including timelines and scope-of-practice requirements.
Track required reentry metrics, service delivery, and outcome measures.
Maintain strict confidentiality and adhere to HIPAA, state regulations, and facility protocols.
Identify appropriate medical, behavioral health, housing, transportation, and social support resources based on client needs.
Coordinate referrals and ensure clients have contact information, appointment details, and transportation planning at release.
Provide guidance on accessing community benefits, reentry programs, medication assistance, and peer support services.
Participate in quality monitoring, program audits, and Medicaid compliance reviews.
Assist with improvement initiatives related to reentry workflows, documentation accuracy, and service delivery.
Maintain awareness of regulatory changes related to rTCM, Apple Health, and justice-involved reentry services.
Support reentry team projects, training, and workflow improvements.
Perform other tasks as assigned.

Benefits

Competitive Pay and MVP Bonus Program
Benefits package including Medical, Dental, and Vision insurance for you and your family
Preferred Pharmacy Network options
MDLIVE virtual Provider telehealth options
Wellness program
Health Savings Accounts and Health Reimbursement Account options with company match
Employer-paid Life Insurance Policy/AD&D, Long-Term Disability and Short-Term Disability coverage
Optional Voluntary coverage for Life Insurance, Accident, Critical Illness, and Hospital Indemnity plans
Paid portion of Maternity Leaves
Employee Assistance Program
Generous Paid Time Off (PTO) including 10 Holidays and flexible Floating Holidays
Participation in the MEDIKO 401(k) Retirement Plan with company match
Employee Referral Bonuses
Tuition Reimbursement Assistance Plan
Free Continuing Education
Access to Perks and Discounts at nationally recognized chains, service providers and retailers