Manager

• Responsible for care management within the scope of licensure for members with complex and chronic care needs
• Assessing, developing, implementing, coordinating, monitoring, and evaluating care plans designed to optimize member health care across the care continuum
• Performs duties primarily in the field with some being done telephonically
• Involves traveling to attend health plan-sponsored events, individual and group presentations
• Ensures member access to services appropriate to their health needs
• Conducts assessments to identify individual needs
• Implements care plans and coordinates internal and external resources
• Monitors and evaluates effectiveness of care management plans
• Assists in problem solving with providers, claims or service issues
• Partner with community health organizations, advocacy groups, and outreach teams to strengthen member connections
• Provide education on chronic conditions, medication adherence, preventive screenings, nutrition, and self-care

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