About the job
- Evaluate the patient's current health condition, resource use, historical and current treatment plans, prognosis, and both short-term and long-term goals.
- Employ strong assessment skills and sound judgment to develop a tailored care plan that includes specific objectives, goals, and interventions aimed at fulfilling the patient's needs and achieving optimal outcomes.
- Facilitate coordination of services among Primary Care Physicians (PCP), specialists, medical professionals, and non-medical staff to address the comprehensive medical and socio-economic requirements of clients.
- Provide education to both patients and providers.
- Assist members in accessing community-based services effectively.
- Oversee referrals to community organizations, medical care, and additional services to enhance the members’ overall care management strategy.
- Actively contribute to integrated team care management discussions.
- Identify and report any risk management quality issues to the appropriate channels.
- Manage a caseload that includes a higher proportion of complex cases compared to Care Manager I, reflective of experience.
- Input and maintain assessments, authorizations, and relevant clinical data within various medical management systems.

