Case Manager, Hawaiian Islands

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Aloha Care’s leadership empowers and engages its employees by recognizing outstanding job performance and collaboration. We share organization-wide updates during quarterly All Staff meetings. We encourage participation in volunteer and educational opportunities. We put a high value on honesty, respect, and trust-building. We encourage open-door, two-way, and frequent communication.

Aloha Care’s comprehensive benefits package includes low-cost medical, dental, drug and vision insurance, paid time-off, 401k employer contribution, referral bonus and pretax transportation and parking program.

The Case Manager d evelops, assesses, and facilitates complex care management activities for primarily mental and behavioral health needs members to provide high quality, cost-effective healthcare outcomes including personalized care plans and education for members and their families related to mental health and substance use disorder.

• Evaluates the needs of the member via phone or in-home visits related to the resources available, and recommends and/or facilitates the care plan/service plan for the best outcome, which may include behavioral health, substance use and social determinant needs
• May perform telephonic, digital, home and/or other site visits outreach to assess member needs and collaborate with resources.
• Develops ongoing care plans for members with high level acuity and works to identify providers, specialists, and community resources needed for care including mental health and substance use disorders.
• Coordinates as appropriate between the member and/or family/caregivers, community resources, and the care provider team to ensure identified services are accessible to members.
• Monitors care plans/service plans and/or member status and outcomes for changes in treatment side effects, complications and clinical symptoms and provides recommendations to care plan/service plan based on identified member needs
• Participates in Interdisciplinary team meetings as appropriate.
• Facilitates care coordination and collaborates with appropriate providers or specialists to ensure members have timely access to needed care or services.
• Collects, documents, and maintains member information and care management activities to ensure compliance with current state, federal, and third-party payer regulators.
• Provides education to members and their families on procedures, healthcare provider instructions, treatment options, referrals, and healthcare benefits, which may include behavioral health and social determinant needs.
• Provides feedback to leadership on opportunities to improve and enhance care and quality delivery for members in a cost-effective manner.
• Upon notification of a crisis the CM, and CM supervisor, as necessary, shall triage and employ necessary interventions to assist member recover from the crisis. If imminent danger is suspected or present activates emergency services, as necessary and consistent with training and policy.
• Perform tasks that align with and support departmental and organizational objectives.
• Ensures compliance with all state and federal regulations, including HIPAA standards of confidentiality of protected health information, reporting critical incidents and reporting of quality-of-care issues.
• All other duties assigned.
• Adhere to regulatory compliance and quality guidelines as well as Aloha Care policies and procedures.
• Responsible for maintaining Aloha Care’s confidential information in accordance with Aloha Care…