Manager

• Visiting members in their homes to evaluate for appropriateness for waiver services, writing the waiver and submitting for approval
• Develops a proactive plan of care to address identified issues to enhance the short and long-term outcomes
• Uses clinical tools and information/data review to conduct an evaluation of member's needs and benefits
• Applies clinical judgment to incorporate strategies designed to reduce risk factors and barriers
• Conducts assessments that consider information from various sources, such as claims
• Uses a holistic approach to assess the need for a referral to clinical resources and other interdisciplinary team members
• Collaborates with supervisor and other key stakeholders in the member’s healthcare in overcoming barriers in meeting goals and objectives
• Utilizes case management processes in compliance with regulatory and company policies and procedures
• Utilizes motivational interviewing skills to ensure maximum member engagement

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