Join our dynamic team at Independent Living Systems (ILS) as a Clinical Care Manager. ILS, alongside its affiliated health plans, is dedicated to enhancing the quality of life and promoting independence for vulnerable populations.
About the Role
The Clinical Care Manager is essential in coordinating and overseeing patient care to achieve optimal health outcomes. In this role, you will manage care plans, collaborate with multidisciplinary healthcare teams, and serve as a critical liaison between patients, families, and providers. You will assess patient needs, facilitate access to necessary services, and monitor progress to adapt care strategies effectively.
By leveraging your clinical expertise and organizational skills, you will enhance patient satisfaction and elevate the quality of care provided. This position aims to ensure that care delivery is efficient, patient-centered, and adheres to best practices and regulatory standards.
Minimum Qualifications
- Bachelor's degree in Nursing, Social Work, Healthcare Administration, or a related field.
- A minimum of 5 years of experience in clinical care coordination or case management.
- Knowledge of and experience working with community agencies and programs.
- Current and valid professional BSW, MSW, or LVN/RN licensure in the State of CA.
- Experience with Medi-Cal eligibility guidelines, application, and renewal/redetermination process.
- Strong problem-solving and customer service skills.
- Must be a California resident during employment.
- Valid California Driver's License required.
- Personal vehicle usage, with current vehicle registration, is necessary.
- Proof of auto insurance is required, maintaining CA minimum coverage.
- CPR Certification mandatory.
- Relevant experience may substitute for educational requirements on a year-for-year basis.
Preferred Qualifications
- Master's degree in Nursing, Social Work, Public Health, or Healthcare Administration.
- Certification in Case Management (CCM) or equivalent credential.
- Experience within California's healthcare system and familiarity with state-specific healthcare policies.
- Expertise in managing chronic disease populations and complex care cases.
- Bilingual abilities, particularly in Spanish, are advantageous for communicating with diverse patient populations.
Responsibilities
- Develop, implement, and monitor individualized care plans for patients with complex medical needs.
- Coordinate communication among healthcare providers, patients, and families to ensure continuity of care.
- Conduct comprehensive assessments to identify patient needs, risks, and barriers to care.
- Facilitate referrals to appropriate healthcare services and community resources.
- Track patient progress and outcomes, adjusting care plans as necessary to meet evolving needs.
- Ensure compliance with healthcare regulations, policies, and quality standards.
- Provide education and support to patients and families regarding treatment plans and health management.
- Collaborate with insurance providers and case management teams to optimize resource utilization.
