Job Title: Case Manager
Department: Enabling Services
Location: Valley-Wide Canon City (1 vacancy)
Location: Valley-Wide Buena Vista (1 vacancy)
Position Type: Full-Time (2 positions)
Pay Unit: Hourly
Pay Range: Hourly – Min: $16.00 – Max: $19.00 (based on qualifications and experience)
($1.00/hour shift differential for weekday hours worked after 5:00 p.m. and weekend hours)
- Health, Dental, Vision Insurance, HRA, FSA, DCA, Retirement Plan
- Aflac – Group Accident, Group Critical Illness, Hospital
- MASA – Employer paid Air Ambulance Coverage
- Paid Leave: Vacation – 10 days accrued/year, Sick – 12 days accrued/year, Holidays – 8 days/year
- (Benefits after one year of employment.) Retirement Match, Employer paid Basic Life, LTD, STD
Primary responsibility is to provide case management services to patients by connecting them with services that appropriately meet their needs by reducing barriers to health care services and effectively directing patients to services that can help further optimize their health status.
Candidate must be able to produce work with a high degree of accuracy and attention to detail with a history of demonstrating efficient multitasking skills and prioritization of work assignments.
Primary Duties & Responsibilities:
Provide navigation services, which support the medical and dental delivery system.
- Provide a service description to each patient referred for case management services.
- Complete a comprehensive assessment of referred patients by exploring clinical needs, psychosocial needs and social determinants of health to assist in effective health maintenance, adjustment, and improvement of patient.
- Participate in a medical home model of care using a team-based approach, including helping patients identify a Primary Care Provider, Primary Dental Provider, participate in Team Huddles, and develop and evaluate progress with individual health care and dental care treatment plans.
- Facilitate patients and families through adjustment processes including understanding medical and dental recommendations, decision-making regarding care management, options for care and available resources.
- Provide application assistance, including financial eligibility assistance, where appropriate.
Provide Care Coordination and Referral Services
- Ensure care coordination is delivered from a centralized resource of a primary care medical home.
- Expedite referrals for medical, dental, ancillary, and community based services for patients and their families and follow-up for completion
- Identify patient barriers completing referrals
- Provide one-to-one health education, disease self-management, and goal-setting interventions as appropriate and relates to primary health issues, and track progress toward goals.
- Build and use effective communication strategies among family members, specialists, community professionals and other significant members associated with the patient’s care plan.
- Document and review pertinent case management and care coordination activities in the Electronic Health Record, using a modified SOAP format, or appropriate NextGen data collection tools.
Dental Case Manager Specific Duties
- Dental Treatment Plan Management
- Meet with each patient at time of treatment plan creation to facilitate signing of plan, explaining options for treatment, determine financial assistance needs.
- Assist patients with scheduling sequence of appointments corresponding to planned treatment.
- Monitor, document and track all pre-authorizations submitted, approved, pending, denied and follow-up as needed.
- Monitor, document and track all dental referrals and close the loop when completed.
- Dental Treatment Plan Management
Participate in Improvement Initiatives
- Collect and prepare specific data entry for all relevant Case management programmatic reports and help measure quality and identify, test, refine and implement practice improvements.
- Participate in community programs and activities
- Participate in organizational outreach activities as assigned.
- Research, find, and link resources, services and support available for patients
Must foster a culture of patient and family centered care, service, quality and safety excellence, while improving patient experience, employee experience and community relations.
Knowledge and Skills:
- Must be familiar with community agencies and have the ability to work independently with internal & external customers
- Have a core philosophy or values consistent with a family-centered approach to care.
- Demonstrate a sensitivity and responsiveness to varying cultural characteristics and beliefs and have a spirit of kindness and concern
- Maintain professionalism and positive attitude.
- Bilingual (Spanish/English) is preferred.
Education and Experience:
Bachelor’s or Master’s degree in human service field or licensure in health field; relevant professional work experience is preferred
Requirements and Conditions:
- Drug screen is required
- Background check is required
Applications must be submitted by: Applications will be accepted until position is filled.
Valley-Wide Health Systems, Inc. is an Equal Opportunity Employer:
We do not discriminate on the basis of race, color, religion, national origin, sex, age, disability, or any other status protected by law or regulation. It is our intention that all qualified applicants be given equal opportunity and that selection decisions be based on job-related factors.