V-Tech Solutions, Inc. is looking for Licensed Case Managers to support our client! We are looking for detailed oriented and passionate individuals who are ready to provide the best possible care and service to those in need in the D.C. area.

Under the direction of the Senior Case Manager, the Case Manager (CM) is responsible for providing comprehensive coordination services to enrollees. The CM routinely communicates with members on their assigned caseload to assess their needs; develop, monitor, and evaluate treatment plan progress; and assist with coordinating care and referring to appropriate services for members who have moderate to complex medical and psychosocial needs. This position is 80% work-for-home, with the other 20% work in the field, as needed.

Job Responsibilities Include:

• Managing a caseload as outlined by CASSIP and Care Management Leadership
• Maintains compliance in accordance with contractual and care management requirements
• Contacts enrollee at predetermined intervals based on stratification level or more frequently, as needed
• Conducts face-to-face visits at a frequency determined by the enrollee’s assigned stratification level or more if needed, with each enrollee/caregiver in their homes, physician’s offices, or other mutually agreed upon locations
• Assesses enrollees on enrollment and at intervals determined by the enrollee’s stratification level to identify needs/barriers and close gaps in care

• Identifies over/under utilization promptly and takes appropriate action according to organizational policy.
• Upon gathering health and mental/behavioral health, environmental, psychosocial, and educational information, the CM develops, implements, and updates an accurate individualized comprehensive care coordination plan for each assigned enrollee in collaboration with the PCP and/or other multi-disciplinary team members including public agencies
• Completes routine care coordination and care management activities with attention to quality, timeliness and in compliance with company policy and national standards
• Consults with Senior Care Manager to review and prioritize cases, set objectives, identify, and report potential risk and utilization concerns
• Seeks advice from Senior Care Manager or other designated person with expertise in specialty areas when necessary

• Accurately and timely documents enrollee findings and interactions according to organizational policy
• Participates in disposition and discharge planning activities. Contributes to the discharge plan in a timely manner, taking into consideration enrollee/family/significant others and match to healthcare resources
• Assists assigned enrollees and their caregivers in understanding the importance of EPSDT and compliance with all health services. Strives to achieve target rate of compliance for preventive medical and dental services
• Applies advanced knowledge of conditions of target population/standard approaches to care management and care coordination to assigned enrollees
• Refers enrollee/caregiver to appropriate vendor(s) on DME/assistive technology use. Educates on medication administration, about their conditions, and techniques for self-management within the scope of license. Refer, as needed, to appropriate vendor for additional education.

• Assist enrollees in planning for transitions of care to include but not limited to transitioning from Early Intervention to DCPS; from pediatric to adult providers; transitioning out of the program when the enrollee ages out or is disenrolled for any reason; from outpatient to inpatient or the reverse; and entering or exiting the custody of CFSA, DYRS or any type of institutional care

Requirements:

• MUST be Licensed in DC as a Social Worker (LICSW, LGSW, LSWA or RN)
• Master’s Degree Required

• 3 years of experience in healthcare or related experience in managed care and/or care management
• 3 years of experience in clinical or community resource settings
• Effective verbal and written communication skills
• Bilingual (Spanish speaking) preferred
• Familiar with medical terminology

• Familiarity with computer systems and applications, particularly in Microsoft Office suite
• Strong organizational skills
• Ability to interpret and apply departmental requirements

Location:

Washington D.C. – candidate must live in the DMV area.

E/O/E

Apply Here: https://v-techsolutions.applicantstack.com/x/apply/a2susz9o45pa