Location:
Calmont Operations Building
Department:
STAR/CHIP CM
Shift:
First Shift (United States of America)
Standard Weekly Hours:
40
Summary:
Performs case management activities across the continuum of care to promote and facilitate quality, cost-effective outcomes and minimize fragmentation of health care delivery for the assigned member population. The Health Plan Case Manager identifies and coordinates short and long-term needs of catastrophically/chronically ill and/or injured children/adolescents and their families. Members may have behavioral health conditions, pediatric conditions, high-risk pregnancy, targeted chronic conditions, or need transition of care services. The Case Manager acts as a member advocate, facilitates, communication, and coordinates care with physicians, clinics, hospital facilities, family, caregivers, and other healthcare providers and implements creative solutions to meet member's healthcare needs without compromising quality outcomes. Expectations also include supporting health risk reduction through behavioral change and patient education. Case Management activities are completed primarily by telephone. Must be able to: Communicate effectively verbally and in writing; Provide excellent telephonic customer service; Organize and prioritize multiple activities; Work with individuals from diverse cultural, social, and economic backgrounds.
Additional Information:
Required Education/Experience:
Master of Social Work degree from an accredited school.
Three (3) years' experience in a case management role is required; five (5) years preferred.
Familiar with using Microsoft Office software, general computer knowledge, and strong typing skills.
Knowledge of case management standards of practice, motivational interviewing, and supporting behavioral change.
Experience with case or disease management in a health plan environment is preferred.
Pediatric experience is desirable.
Bi-lingual (English/Spanish) preferred.
Required Licensure / Certification:
About Us:
Cook Children's Health Plan
Cook Children's Health Plan provides vital coverage to nearly 120,000 people in low-income families who qualify for government-sponsored programs in our six county service region. Cook Children's Health Plan provides health coverage for CHIP, CHIP Perinatal, STAR (Medicaid) and STAR Kids Members in the Tarrant county service area. The counties we serve includes Tarrant, Johnson, Denton, Parker, Hood and Wise.
Cook Children's is an EOE/AA, Minority/Female/Disability/Veteran employer.