Care Coordinator-MyCare

Job Details

• Job Location:
  
  GREEN - UNIONTOWN, OH 44685
• Salary Range: $64,700.00 - $79,200.00 Salary/year
• Function(s):
  Provides care coordination for managed care consumers in the MyCare Ohio (fully delegated care coordination) waiver program.

• Delivers person-centered care coordination and management for MyCare Ohio enrollees through a collaborative, team-based approach that addresses medical and social needs to improve overall health outcomes.
• Evaluate assessment data to determine ongoing program eligibility, care needs, and service options.
• Conduct initial and ongoing Waiver Service Needs Assessments using ODM approved tools and care management to determine ongoing program eligibility, care needs, and service options.
• Complete home visits and phone contacts according to assigned tier to ensure health, safety, service satisfaction and provide education to members.
• Complete significant change event assessments that require a medication reconciliation and/or comprehensive assessment within required time frames.
• Collaborate with the Department of Job and Family Service to establish and/or maintain Medicaid eligibility.
• Assist with telephonic after-hours coverage.
• Complete all required documentation within 3 business days of that activity.
• Provide education about Waiver services options, self-directed care, and appeal rights. Link members with network providers as well as Medicare services to ensure coordination of care. Provide education about reporting abuse, neglect, and exploitation.
• Manage transitions of care by attending discharge planning meetings and ensure timely provision of supports while utilizing all benefits available to member such as the HOME Choice Program.
• Offer and link members, as appropriate, to health education, disease management and wellness/prevention coaching.
• Develop, implement and update the person-centered care plan according to the program contract following receipt of the request for Waiver services for all members, including direct Care Coordination interventions to address a consumer’s unstable conditions. The person-centered care plan must include disaster preparedness/back up plans and scope of service to address a member’s unstable conditions.
• Develop and lead the Interdisciplinary Care Team meetings.
• Advocate on behalf of members and/or caregiver/family and assist individuals in securing appropriate services and care settings.
• Disenroll all ineligible members from the program.
• Respond to questions, problems, or complaints from members, providers, and advocates. Apply judgments and perform clinical practice based upon education, experience and professional practice standards.
• Complete required training topics including such topics as health equity, implicit bias, disability competency, and incident reporting

• Experience in home health care, medical social work or geriatrics
• Registered Nurse in the State of Ohio or Licensed Social Worker in the State of Ohio
• At least one year of experience working with persons with disabilities/chronic conditions and LTSS

• Previous Care Management experience
• One year of experience in home care, geriatrics, behavioral health, or long-term care.
• Knowledge of chronic disease management.