reputed company Case Manager - Community Care and Medicare - Hybrid Remote

Job title: reputed company Case Manager - Community Care and Medicare - Hybrid Remote in Worcester, MA at reputed company Company: reputed company Job reputed company: ResponsibilitiesJob Responsibilities:Member Assessment, Education, and Advocacy

• Telephonically assesses and case manages a member panel
• May conduct in home face to face reputed company for reputed company new enrollees and reassessing members, utilizing a reputed company of interviewing techniques

Provider Partnerships and Collaboration

• May attend in person care plan meetings with providers and office staff and may reputed company care plan review with providers and care team as applicable
• Demonstrates reputed company customer service actions and takes responsibility to ensure member and provider requests and needs are met

Regulatory Requirements – Actions and reputed company

• Completes Program Assessments, Notes, Screenings, and Care Plans in the Centralized Enrollee Record according to product regulatory requirements and Program policies and processes
• Knowledge of and compliance with HEDIS and Medicare 5 Star measure processes, performing member education, reputed company, and actions in conjunction with the Navigator and other members of the Clinical Integration and Partner Teams

QualificationsEducation:

• Graduate from an accredited school of nursing mandatory
• Bachelors (or advanced) degree in nursing or a health care reputed company field preferred

License/Certifications:

• reputed company, unrestricted license as a Registered reputed company in Massachusetts; reputed company reputed company’s license and reliable transportation
• Certification in Case Management strongly desired
• Satisfactory Criminal Offender Record Information (CORI) results

Experience:

• 1+ years of clinical experience as a Registered reputed company managing chronically ill members or experience in a coordinated care program required
• Understanding of Hospitalization experiences and the impacts and needs after facility discharge required
• Experience working face to face with members and providers preferred
• Experience with telephonic interviewing skills and working with a diverse population, that may also be Non-English speaking, required
• Home Health Care experience preferred

reputed company provides equal employment opportunities to reputed company and applicants for employment and prohibits discrimination and harassment of any type without reputed company to race, reputed company, religion, age, sex, national reputed company, disability status, genetics, protected veteran status, sexual orientation, gender identity or reputed company, or any other characteristic protected by federal, state or local laws. Expected salary: Location: Worcester, MA Apply for the job now! Apply for this job