Member Care Services Associate-Quest Integration

Member Care Services Associate-Quest Integration

Job Summary
Provides case management services to Kaiser Permanente Quest Integration (QI) members and their families to help navigate personal, social, financial, and medical needs. Works with QI RN Manager to assign QI members (adults, seniors and children) with special health care needs to appropriate care manager(CM)/care coordinator(CC). Works with RN Manager to develop QI processes for successful care management integration. Coordinates monthly collaborative Care Rounds.

Develops and implements tracking systems for QI processes including, but not limited to, QI Face to Face Health Functional Assessments (HFA), Early and Periodic Screening, Diagnosis and Treatment (EPDST) including CM/CC member follow-ups. Develops and implements QI care plan summary templates for KP EHR. Develops and implements a tool box for initial HFA and reassessments for CM/CC.

• Develops the QI care management tool box for initial and reassessment materials needed for a home visit. Develops QI check lists and implements them.
• Receives and performs initial triage of paraprofessional. Assists with resource development. Networks with other community based services. Works closely with CM/CC for referral regarding Home Community Based Services (HCBS)/Durable Medical Equipment (DME), dental services, Social, Emotional, and Behavioral Difficulties (SEBD)/Severely Mentally Ill (SMI), Child Welfare Services, Adult Protection Services (APS), and Developmental Delayed (DD).
• Provides member care services to Kaiser Permanente QI enrollees. Navigates services based on medical, social and psychosocial needs, educates members on QI program and offers assistance as needed.
• Navigates transportation and housing needs for members and/or their families for medical services both Inter island and on the Mainland.
• Works with RN manager to assign QI member caseloads to RN CM and LSW CC. Develops and implements a HFA tracking form for RN CM/LSW CC in home visits and follow-ups.
• Interprets and explains services of Kaiser Permanente QI program to members and families. Acts as QI member and family advocate. Navigates the health care system and health care services available to our members. Acts as liaison to promote Kaiser philosophy and services. Confirms QI coverage to patients and service providers within Kaiser as needed.

Entry level

Full-time

Other

Hospitals and Health Care