**Priority will be given to Washington State Residents**
Who we are
Community Health Plan of Washington is an equal opportunity employer committed
to a diverse and inclusive workforce. All qualified applicants will receive
consideration for employment without regard to any actual or perceived protected
characteristic or other unlawful consideration.
Our commitment is to:
* Strive to apply an equity lens to all our work.
* Reduce health disparities.
* Create an equitable work environment.
About the Role
Assists with and coordinates care management activities under the direction of
an RN or LICSW Case Manager, Supervisor, or Manager. Functions as an
interdependent team member in the areas of member assessment, planning,
facilitation, and advocacy.
To be successful in this role, you:
* Possess a Bachelor’s degree in social work, Practical Nursing Certificate, or
an equivalent bachelor’s degree in a relevant health care field. Candidates
with a bachelor’s degrees in a relevant health care field must have a minimum
of (1) year experience in care coordination or care management either in a
managed care organization, community-based organization, or related workplace
preferred
* Have previous experience as a medical assistant, behavior health technician,
or other social welfare services or an equivalent combination of education
and highly relevant experience preferred or valid Washington State Licensed
Practical Nurse (LPN).
* Have a minimum of one (1) year of clinical and/or care management experience
(required)
* Have proficiency and experience with Microsoft Office products
* Knowledge of Medicare and Medicaid regulations
* Have one (1) year in care management in a health plan, community agency or
Accountable Care Organization (ACO) (preferred)
* Have knowledge of care management systems and planning techniques
* Have experience in care management workflow systems (preferred).
Essential functions and Roles and Responsibilities:
* Communicates with providers to arrange follow up appointments, obtain
clinical records, and assist members with care coordination
* Ensures appropriate coordination of services to members such as any necessary
member transportation needs, obtaining community resources such as food
pantries and housing.
* Coordinates and facilitates services with physical and behavior health care
providers within an episode of care.
* Documents and manages the care management process to include case
identification, assessment, planning and goal prioritization, monitoring,
support, and case closure.
* Participates in clinical outcome data monitoring and collection.
* Assess member health care status and health (medical, behavioral, and social)
history, risks, gaps and utilization.
* Develops plans of care with appropriate member centric interventions.
* Provides behavioral health support and interventions to members in crisis.
* Collaborates with member PCP, specialists, and community resources/vendors to
leverage community resources
* Ensures all care coordination activities are documented medical record system
per established guidelines.
* Support staff in answering member calls including participation in the 5pm
call rotation for crisis calls.
* Other duties as assigned. Essential functions listed are not necessarily
exhaustive and may be revised by the employer, at its sole discretion.
Knowledge, Skills, and Abilities:
* Organizational, time management, and project management skills
* Knowledge of medical terminology, electronic medical records, developmental
disability services, special education IDEA/ADA and healthcare process
(preferred)
* Understanding and experience with health care systems, regulations, policies,
functions, and documentation standards
* Strong written and verbal communication skills; able to communicate with and
collaborate effectively with physicians and allied health care providers
* Comfortable presenting in a group setting
As part of our hiring process, the following criteria must be met:
* Complete and successfully pass a criminal background check
Criminal History: includes review of criminal convictions and probation. CHPW
does not automatically or categorically exclude persons with a criminal
background from employment. The applicant’s criminal history will be reviewed on
a case-by-case basis considering the risk to the business, members,
and/employees.
* Has not been sanctioned or excluded from participation in federal or state
healthcare programs by a federal or state law enforcement, regulatory, or
licensing agency
* Vaccination requirement (CHPW offers a process for medical or religious
exemptions)
* Candidates whose disabilities make them unable to meet these requirements are
considered fully qualified if they can perform the essential functions of the
job with reasonable accommodation.
Compensation and Benefits:
The position is FLSA Non-Exempt and is eligible for overtime. Based on market
data, this position grade is 45 and has a 5% annual incentive target based on
company, department, and individual performance goals.
CHPW offers the following benefits for Full and Part-time employees and their
dependents:
* Medical, Prescription, Dental, and Vision
* Telehealth app
* Flexible Spending Accounts, Health Savings Accounts
* Basic Life AD&D, Short and Long-Term Disability
* Voluntary Life, Critical Care, and Long-Term Care Insurance
* 401(k) Retirement and generous employer match
* Employee Assistance Program and Mental Fitness app
* Financial Coaching, Identity Theft Protection
* Time off including PTO accrual starting at 17 days per year
* 40 hours Community Service volunteer time
* 10 standard holidays, 2 floating holidays
* Compassion time off, jury duty
Sensory/Physical/Mental Requirements:
Sensory*:
* Speaking, hearing, near vision, far vision, depth perception, peripheral
vision, touch, smell, and balance.
Physical*:
* Extended periods of sitting, computer use, talking, and possibly standing
* Simple grasp, firm grasp, fine manipulation, pinch, finger dexterity,
supination/pronation, wrist flexion
Mental:
* Must have the ability to learn and prioritize multiple tasks within the scope
and guidelines of the position and its applicable licensure requirements,
many requiring extremely complex cognitive capabilities. Must be able to
manage conflict, communicate effectively and meet time-sensitive deadlines.
Work Environment:
Office environment Employees who frequently work in front of computer monitors
are at risk for environmental exposure to low-grade radiation.
*Candidates whose disabilities make them unable to meet these requirements are
considered fully qualified if they can perform the essential functions of the
job with reasonable accommodation.
*The above is intended to describe the general content of and the requirements
for satisfactory performance in this position. It is not to be construed as an
exhaustive statement of the duties, responsibilities, or requirements of this
position. Job descriptions may be updated or changed to reflect business needs.