Bilingual Case Manager

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Reference Code: 6997

Position: Bilingual Case Manager

Location: Miami-Dade County, FL 33012 / Monroe, FL 33034

Duration: 6-month Contract with possible extension

Pay Rate: $34.50/hr

 

Our client, a Fortune 500 multi-state healthcare organization, is looking to hire a Case Manager who will be responsible for responsible for health care management and coordination of client?s members in order to achieve optimal clinical, financial and quality of life outcomes. The Case Manager is to work with members to create and implement an integrated collaborative plan of care. Coordinates and monitors client?s member?s progress and services to ensure consistent cost-effective care that complies with client?s policy and all state and federal regulations and guidelines. The Case Manager role has field work involved to visit members in the program, but documentation and such is done from home. The Case Manager?s day-to-day responsibilities include managing a caseload of up to 60 members community based and ensuring they receive services needed to remain in the community safely and comply with contractual obligations set forth by our regulator. The Case Manager is expected to work Monday ? Friday 8:00 AM – 5:00 pm EST.

 

The Case Manager?s essential functions are as follows:

  • Provides case management services to members with chronic or complex conditions including:
    • Proactively identifies members that may qualify for potential case management services.
    • Conducts assessment of member needs by collecting in-depth information from client?s information system, the member, member?s family/caregiver, hospital staff, physicians, and other providers.
    • Identifies, assesses, and manages members per established criteria.
    • Develops and implements a case management plan in collaboration with the member, caregiver, physician and/or other appropriate healthcare professionals to address the member needs.
    • Performs ongoing monitoring of the plan of care to evaluate effectiveness.
    • Documents care plan progress in client?s information system.
    • Evaluates effectiveness of the care plan and modifies as appropriate to reach optimal outcomes.
    • Measures the effectiveness of interventions to determine case management outcomes.
  • Promotes integration of services for members including behavioral health and long-term care to enhance the continuity of care for client?s members.
  • Conducts face to face or home visits as required.
  • Maintains department productivity and quality measures.
  • Manages and completes assigned work plan objectives and projects in a timely manner.
  • Demonstrates dependability and reliability.
  • Maintains effective team member relations.
  • Adheres to all documentation guidelines.
  • Attends regular staff meetings.
  • Participates in Interdisciplinary Care Team (ICT) meetings.
  • Assists orientation and mentoring of new team members as appropriate.
  • Maintains professional relationships with provider community and internal and external customers.
  • Conducts self in a professional manner at all times.
  • Maintains cooperative and effective workplace relationships and adheres to company Code of Conduct.
  • Participates in appropriate case management conferences to continue to enhance skills/abilities and promote professional growth.
  • Complies with required workplace safety standards.

 

Job Qualifications:

  • The Case Manager must have a Bachelor?s degree and at least 2 years? experience in social services
  • The Case Manager must meet one of the following qualifications:
    1. The Case Manager with the following qualifications shall also have a minimum of two (2) years of relevant experience:
      1. Bachelor?s degree in social work, sociology, psychology, gerontology, or a related social services field;
      2.  Registered nurse, licensed to practice in the State;
      3. Bachelor?s degree in a field other than social science; or
    2. The Case Manager with a master?s degree in social work, sociology, psychology, gerontology, or a related social services field may substitute experience obtained through a practicum, internship, or clinical rotation on an equivalent basis for up to one (1) year of the experience requirements.
      1. The Case Manager with the following qualifications shall also have a minimum of four (4) years of relevant experience: Licensed Practical Nurse, licensed to practice in the State.
    3. The Case Manager without the aforementioned qualifications may substitute professional human service experience on a year-for-year basis for the educational requirement. The Case Manager without a bachelor?s degree shall have a minimum of six (6) years of relevant experience.

 

  • The Case Manager must be bilingual in English and Spanish
  • The Case Manager must be local to Miami-Dade County/Monroe
  • The Case Manager must have valid driver?s license with good driving record and be able to drive locally.
  • The Case Manager must have demonstrated ability to communicate, problem solve, and work effectively with people.
  • The Case Manager must have excellent organizational skill with the ability to manage multiple priorities.
  • The Case Manager must have the ability to work independently and handle multiple projects simultaneously.
  • The Case Manager must have strong analytical skills.
  • The Case Manager must have knowledge of applicable state, and federal regulations.
  • The Case Manager must have knowledge of ICD-9, CPT coding and HCPC.
  • The Case Manager must have knowledge of SSI, Coordination of benefits, and Third-Party Liability programs and integration.
  • The Case Manager must have familiarity with NCQA standards, state/federal regulations, and measurement techniques.
  • The Case Manager must have in depth knowledge of CCA and/or other Case Management tools.
  • The Case Manager must have the ability to take initiative and see tasks to completion.
  • The Case Manager must have computer skills and experience with Microsoft Office Products.
  • The Case Manager must have excellent verbal and written communication skills.
  • The Case Manager must have the ability to abide by client?s policies.
  • The Case Manager must be able to maintain regular attendance based upon agreed schedule.
  • The Case Manager must be able to maintain confidentiality and comply with Health Insurance Portability and Accountability Act (HIPAA).
  • The Case Manager must be skilled at establishing and maintaining positive and effective work relationships with coworkers, clients, members, providers, and customers.

 

 

For more information on the Case Manager, please call our Recruiter directly at (847) 480-3449. To submit your application, click on the 'Apply for Job' link below or send your resume directly to Alyssa.Garcia@bluestonestaffing.com.

 

blueStone Staffing recruits top talent for some of the most desired companies on a contract, contract-to-hire and direct hire basis. We take pride in presenting our candidates with great opportunities they may not have exposure to elsewhere. By working with blueStone, you'll have access to rewarding job opportunities, competitive compensation, and industry leading benefits packages. We look forward to helping you land your next career opportunity and achieving your goals

 

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