Case Manager - Medicare Advantage

Job description

Job Description Dependent on clinical discipline, the Case Manager / Health Coach coordinates appropriate care, resources and/or services of selected member populations. Provides guidance and promotes effective utilization and monitoring of health care resources to drive quality care for our members. Collaborates as needed with varied members of the healthcare team to achieve optimal clinical and/or resource outcomes. What You'll Do: - Serve as a team member on a multidisciplinary team, coordinating care, resources and/or services for members to achieve optimal clinical and resource outcomes. - Utilize applicable clinical skillset and perform comprehensive assessments to determine how to best collaborate with members, family, internal partners and external services/providers on plans for treatment, appropriate intervention and/or discharge planning. - Develop a member-centric plan tailored to members’ needs, health status, educational status and level of support needs; identify barriers to meeting goals or plan of care - Utilize community resources and funding sources as needed in the development of the plan of care. - Perform ongoing monitoring and management of member which may i...