Position Purpose
With minimal supervision; plans, directs, and evaluates total managed care options for members and functions as part of an interdisciplinary team in accordance with established philosophy.
The population of membership includes those with chronic medical conditions as well as mental health and AODA issues.
Relates effectively with others for continuity of care; maintains satisfactory relations with others, maintains accurate and complete records, and upgrades policies, procedures, and skills of others within the department.
Essential Position Functions
Initiate and implement a managed health care plan for health plan members.
Work with members through difficult situations and provide support and tools to enable them to help themselves.
Assess the social and emotional needs of members and work with them to develop strategies to foster their independence.
Advocate on behalf of the member regarding accessibility of services; reduce resource consumption, and achieve positive member outcomes.
Identify problems and provide the best possible solution.
Accurately and promptly implement solutions that assist with member education and care management programs.
Collaborate with co-workers and outside resources regarding continuity of care options.
Participate in planning changes and improvements.
Maintain a professional approach with the highest standard of confidentiality.
Cooperate and maintain good rapport with staff, other departments, members, providers, and agencies involved in providing quality care to the member.
Maintain the standards of accurate and complete documentation and reporting.
Remain calm when accepting urgent requests or phone calls from others.
Establish referral network/linkages with outside agencies for members.
Attend professional workshops, seminars and in-service training.
Maintain up to date knowledge of all changes in relevant discipline.
Create a working climate that provides growth and job satisfaction to others within the department.
Act as liaison between GHC and homeless assistance coalitions.
Minimum Requirements of the Position
Associate degree in social work, human services, registered nurse or equivalent degree required.
Bachelor’s degree preferred.
Prefer candidates with three to five years of related social work, human services, case management or related experience.
Must be able to obtain the Certification of Case Management (CCM) or equivalent case management certification within a designated time frame as determined by the CMO.
Must demonstrate high degree of customer service skills, including excellent verbal and written communication skills.
Must be able to work under pressure with strong attention to detail.
Ability to learn and adapt in a changing environment.
Ability to work with and influence a diverse population.
This full time position offers an outstanding benefit package, including three weeks of vacation the first year, a generous retirement plan, health and dental insurance, a wellness program, and much more! If you are interested in working for an organization focused on a team atmosphere and is dedicated to providing exceptional service submit your resume today! Send resume to: resumes@group-health.
com.
Group Health Cooperative of Eau Claire is an affirmative action and equal opportunity employer.
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