Community Health Plan of Washington

Manager

• Responsible for the operational delivery of the plan’s case management and coordination programs and processes.
• Provides case management services for CHPW Pediatric/Adolescent/NICU/Perinatal members with short term, long term, stable, unstable, and predictable course of illness, and/or highly complex medical/behavioral and social conditions.
• The goal is to improve members' quality of life and ensure cost-effective outcomes by using internal and community-based resources.
• Advocates on behalf of members and facilitates coordination of resources required to help members reach optimum functional levels and autonomy within the constraints of their disease conditions.
• Works within a multi-functional team to connect with providers, members, caregivers, contracted vendors, community resources, and health plan partners to assess the member's health status, identify care needs and ensure access to appropriate services to achieve positive health outcomes.
• Assesses, evaluates, plans, implements, and documents care of members within the organization’s clinical database system, in accordance with organizational policies and procedures.
• Responsible for the assessment of members, including identifying and coordinating access to the appropriate level of care and treatment.
• Uses the assessment information to assign the appropriate risk and complexity level, and create and document a care plan in coordination with the member, family and health team input.

Case Manager I – Pediatric, Adolescent, Youth, NICU, Perinatal

• Responsible for pre-release planning and short-term case management of members releasing from city and county jails
• Provide short-term case management services for members with highly complex behavioral health, medical, and social conditions
• Connect with members, correctional facility staff, providers, caregivers, contracted vendors, community resources, and health plan partners to assess the member's reentry into the community
• Identify care needs and ensure access to appropriate services for positive health outcomes
• Meet with the justice involved members via phone or video conferencing at city and county jails
• Maintain CM records and documents within the JIVA system
• Schedule medical, mental health, dental, and/or vision appointments in accordance with the members release date

Case Manager I – Pediatric, Adolescent, Youth, NICU, Perinatal

Behavioral Health Transitions of Care Manager – Carceral Transitions