The role of the Case Manager is to promote quality, cost-effective outcomes for a population by facilitating collaboration and coordination across settings, identifying member needs, planning for care, monitoring the efficacy of interventions, and advocating to ensure member’s receive services and resources required to meet desired health and social outcomes. The Case Manager is responsible for providing patient centered care across the care continuum.

ROLE RESPONSIBILITIES

• Collect relevant clinical data to support the care planning process
• Care Plan support, intervention, and prioritization to transition members to optimal levels of health and self-management
• Participate in interdisciplinary team meetings as required
• Collaboration across providers and healthcare settings to ensure optimal quality outcomes for an assigned population
• Provide transition of care interventions as required
• Facilitate care coordination, self-management planning, discharge planning, and health education for an assigned population
• Facilitate linkage to appropriate community resources to address social determinants of health
• Adjudicate referrals and apply evidence-based clinical criteria to coordinate member care needs across all ...