Care Manager; Manitowoc); Home-Based Field

The Care Manager, as part of an interdisciplinary team (IDT), serves frail elders, adults with physical disabilities and adults with intellectual/developmental disabilities who are members of Lakeland Care (LCI). The team’s goal is to promote the overall well-being of the members LCI serves by providing high quality, person-centered, outcome-based care.

Under general direction of the Care Management Supervisor, this position provides care management and service coordination to LCI members. As a member of the IDT, the Care Manager arranges for provision of services and supports based on a comprehensive assessment of the member's identified outcomes and needs. The IDT monitors the provision of services based on the member-centered plan per LCI policy and procedures, and Department of Health Services (DHS) contract requirements.

• As part of an interdisciplinary team (which also includes an RN Care Manager and the member and/or legal representative), conduct a comprehensive assessment of the member's outcomes, needs and risks; and conduct a reassessment as the member’s outcomes and/or condition changes.
• Collaborate with the RNCM to coordinate acute and primary care services, care transitions, and related follow-up care.
• Develop, coordinate, monitor and evaluate the members’ outcome-based member-centered plans, considering cost and effectiveness in authorizing services and choosing providers.
• Coordinate care and benefits to ensure a comprehensive support approach, as well as on-going access to federal and state programs.

• Implement risk mitigation strategies to promote the member’s health, safety and independence while respecting the member’s rights.
• Educate members of their rights to appeal and grieve decisions and processes and facilitate the member's participation in the appeal/grievance process.

• Participate in on-going training; maintain current knowledge to ensure compliance with Federal and State regulations, LCI policy and procedure and accepted professional standards.
• Create and maintain member records as required by the Department of Health Services (DHS) contract and LCI policy.

• Coordinate and participate in home visits and care conferences involving the member, their supports, and providers to assess and reassess long-term care needs and coordinate appropriate interventions.
• Participate in the 24-hour on-call rotation as needed.

• Participate in team meetings and internal work groups as required/requested.

• Maintain the confidentiality of member information and protected health information (PHI) as required by State and Federal regulations, including the Health Insurance Portability and Accountability Act (HIPAA) of 1996.

The duties listed above are typical for this position. These are not to be construed as exclusive or all-inclusive. Other duties may be required and assigned.

The Care Management Supervisor provides general direction for this position. Decisions are made within the policies and procedures established by LCI. Significant interaction occurs with other professionals, both inside and outside of LCI. In addition to frequent and direct interaction with LCI members, this position also interacts regularly with LCI staff, and professionals, and medical personnel from outside agencies.

Work will be performed in external locations such as members’ homes, assisted living facilities and other like settings, and remotely or in a designated office environment. Work hours are generally during normal business hours of 8:00 am - 4:30 pm; however, unscheduled evening and weekend work…