TCM Care Manager - Alliance Catchment Area

Job Description

Position:
Care Manager

Department:
Tailored Care Management

Reports To:

Tailored Care Management Supervisor

The Care Manager is part of a multidisciplinary care team providing whole-person care management for Behavioral Health I/DD Tailored Plan beneficiaries. The role spans multiple domains, including physical health, behavioral health, I/DD, traumatic brain injury (TBI), pharmacy, long-term services and supports (LTSS), and unmet health-related resource needs.

• Conduct comprehensive assessments at enrollment, yearly, or during changes in condition.
• Develop, update, and facilitate Care Plans derived from these assessments.
• Utilize person-centered planning, motivational interviewing, and historical review of assessments to identify required supports.
• Address Social Determinants of Health (SDOH), disparities, and complex payer issues in the Plan of Care.

• Assign interventions/plans of care to Extenders [KO1] [JC2] for monitoring and service engagement.
• Coordinate with team members for smooth transitions to appropriate levels of care.
• Participate in the agency’s twenty-four (24) hour coverage for care management.

• Educate members/Legally Responsible Persons (LRP) about care teams, services, rights, the grievance and appeals process, available service options, and payer requirements.
• Promote customer satisfaction through ongoing communication and timely follow-up on any concerns/issues.

• Ensure adherence to service orders/doctor’s orders and obtain necessary releases/documentation.
• Submit necessary documentation to the payer for timely service delivery.
• Maintain all certifications or licensure required for the position and comply with all agency policies and procedures.

• Evaluate the appropriateness of services and ensure the implementation of the plan of care through regular assessments.
• Escalate complex cases to the Supervisor and report critical incidents.
• Attend Behavior Support Plan (BSP) meetings.

• Assist individuals/LRP in choosing service providers, ensuring objectivity.
• Utilize Admission, Discharge, and Transfer (ADT) information to support members admitted, transferred, or discharged from a facility promptly.
• Collaborate with the care team and service providers to develop plans reflecting the individual’s needs and desired life goals.
• Complete all other responsibilities as assigned by the supervisor.
• Visiting members at their living arrangements, such as their own home, a relative's home, a care facility, or any other location, is essential and required to ensure the delivery of high-quality care.

As a valued member of the Health Keeperz team, the Care Manager is expected to embody the principles of the Health Keeperz Barnabas Culture of Encouragement. This involves fostering a supportive and inclusive work environment, promoting teamwork, and upholding the core values of the organization, which include compassion, excellence, ownership, and putting family first.

In your role as Care Manager, you are encouraged to exemplify these values, demonstrating a commitment to the mission of Health Keeperz: caring for all people for the glory of God. By aligning your work ethic and professional conduct with Health Keeperz's mission, vision, values, and culture, you will contribute significantly to the organization’s ongoing success.

Your efforts will play a crucial role in providing high-quality care to the individuals we serve and maintaining productive relationships with our…