<p>This role is eligible for a $10,000 sign on bonus!</p> <p>Job Summary:</p> <p>For members of a defined population, responsible for collaborating with the members of the health care team to facilitate the coordination of appropriate, cost-effective services that are consistent with members plan of care, help achieve their optimal level of independence and enhance quality of life.</p> <p>Essential Responsibilities:</p> <ul> <li>In close collaboration with the member/members family, and members of the health care team, assesses the members health status, functional limitations, psychological status, social support systems, resources, environmental factors, and response to treatment. </li><li>Uses motivational interviewing techniques to identify patients readiness for change, creates appropriate care plan based on assessments, assists member with health system navigation and connection to community resources. </li><li>Provides supportive counseling and education to members, families and caregivers, members of the health care team, and others including end-of-life issues and Advance Directives. </li><li>Effectively manages and coordinates assigned caseload consistent with established criteria. Ensures consistent and reliable documentation of case management activities in compliance with all organization and department standards. </li><li>Facilitates application process for accessing local, state, and federally funded programs (e.g., Medicaid, Medicare, Disability) and/or refers to appropriate community agencies in cases of suspected patient abuse/neglect when identified. </li><li>Coordinates care across the care continuum for members receiving behavioral health and substance abuse services. </li><li>Responsibilities include, but are not limited to, problem identification, psychosocial assessment, financial counseling/referral, accessing community resources, placement for care, guiding the member through health-related legal processes, or consultation and support to other health care professionals. </li></ul>