Field Case Manager I - King County

This position is Remote; however, the candidate will need to reside in and travel throughout the King County region.

Who we are

Community Health Plan of Washington is an equal opportunity employer committed to a diverse and inclusive workforce. All qualified applicants will receive consideration for employment without regard to any actual or perceived protected characteristic or other unlawful consideration.

Our commitment is to:

• Strive to apply an equity lens to all our work. 
• Reduce health disparities. 
• Become an anti-racist organization 
• Create an equitable work environment. 

About the Role

Responsible for the operational delivery of the plan’s case management and coordination programs and processes. Provides case management services for CHPW members with short-term, long-term, stable, unstable, and predictable course of illness, and/or highly complex medical/behavioral and social conditions. The goal is to improve members' quality of life and ensure cost-effective outcomes by using internal and community-based resources.

To be successful in this role, you:

• Possess a bachelor’s degree in nursing or master’s degree in social work and/or related behavior health field (preferred)
• Have a current, unrestricted license in the State of Washington as a registered nurse (RN) (required) OR 
• Have a current, unrestricted license in the State of Washington as a Social Worker (LSWAA, LSWAIC) (required) OR
• Have a current, unrestricted license in the State of Washington as a Mental Health Counselor (LMHC), Mental Health Professional (LMHP), or Marriage and Family Therapist (LMFT) (required)
• Have a current, unrestricted driver’s license in the State of Washington
• Have a minimum of one (1) year case management, home health or discharge planning experience; OR a combination of education and experience which provides an equivalent background OR
• Have minimum of one (1) year facility-based medical or behavioral health experience and/or outpatient psychiatric and substance abuse/substance abuse disorder treatment experience, required; or equivalent combination of education and experience and/or working with children and families. Experience with those who have disabilities and knowledge of Child and Families Services
• Have three (3) years of clinical experience in an acute care and/or outpatient setting (required)
• Proficiency and experience with Microsoft Office products

Preferred

• Have a case management certification
• Are bilingual
• Have managed care (Medicaid and/or Medicare Advantage) experience 
• Have previous experience using Care Management software applications (preferred)

Essential functions and Roles and Responsibilities:

• Advocates on behalf of and facilitates coordination of resources required to help members reach optimum functional levels and autonomy within the constraints of their disease conditions.
• Work on a multi-interdisciplinary care team that collaborates with providers, members, caregivers, contracted vendors, community resources, and health plan partners to assess the member's health status, identify care needs and ensure access to appropriate services to achieve positive health outcomes.
• Assesses, evaluates, plans, implements, and documents the care of members within the organizations’ clinical database system in accordance with organizational policies and procedures.
• Responsible for the assessment of members, including identifying and coordinating access to the appropriate level of care and treatment. Uses the assessment information to assign the appropriate risk and complexity level, create and document a care plan in coordination with the member, family/caregiver and provider input.
• Initiates a plan of care based on member-specific needs, assessment data and the medical/behavioral plan of care.
• Plans care in collaboration with members of the multidisciplinary care team, and considers the physical, behavioral, cultural, psychosocial, spiritual, age specific and educational needs of the member in the plan of care.
• Reviews and revises the plan of care with the interdisciplinary care team to reflect changing member needs based on evaluation of the members’ status, and/or because of reassessment.
• Implements the plan of care through direct member care, coordination, and delegation of the activities of the health care team. Promotes continuity of care by accurately and completely communicating to health care team the status of members for wh