Conduct meaningful outreach, provide education, and drive member enrollment
In partnership with the member, create a Service Plan to guide engagement based on member diagnoses, results of screenings, as well as care gaps
Build measurable goals for members to develop skills and/or strategies for managing challenges and triggers to reduce hospital admissions/readmissions and use of the ER, and record outcomes
Coordinate community resources for each member to support them in achieving their goals as outlined in their Service Plans, created with an emphasis on meeting behavioral health and medical needs, and closing gaps identified in the social determinants of health
Act as an advocate and liaison between the care team (family, physician, facilities, and/or agencies) and member
Schedule appointments, build accountability, and follow-up services for members
Elevate critical incidents and information regarding any quality-of-care concerns
Report hospital diversions, productivity, and other outcomes weekly
Prepare and maintain all required records, reports, consents, and members’ diagnostic records

Bachelor’s Degree required in nursing, social work, or other health and human services discipline
Completion of supervised fieldwork and experience in case management, health, or behavioral health preferred
Experience as a Certified Case Manager (CCM), Community Health Worker (CHW) or Peer Support Specialist (PSS), or Accredited Case Manager (ACM) preferred
Knowledge of local resources, social determinants of health, mental health, substance abuse disorders, violence, and social issues is required

Medical, dental, and vision insurance for you and dependents
401K
11 Holidays and 15 Vacation days
4 Wellness days
Employee Assistance Program and Wellness programs are available to you and dependents
Freedom to design your own workday

TN Case Manager

Key skills