Az-case Management Specialist
Scan (Phoenix, Arizona)

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Description

JOB PURPOSE:

Under the general supervision of the Long Term Care Case Management Supervisor, the Case Manager will ensure that appropriate and cost effective services are authorized in order to promote independence in the most integrated and least restrictive environment. With the involvement of the member and/or member's representative, the Case Manager will develop a written service plan that reflects the agreed upon placement and services that include medical, medically-related social, and behavioral health services to individuals eligible for Arizona Long Term Care System (ALTCS). ESSENTIAL JOB RESULTS:

Perform initial and reassessments within established guidelines as outlined in the AHCCCS Medical Policy Manual (AMPM).
Provide adequate information and training to assist the member, family, additional supports in making informed decisions and choices regarding appropriate service placement to meet the member's needs in the most integrated setting.
In coordination with the member, member's representative/guardian, additional supports, and Primary Care Physician, provide a continuum of service options that will support the expectations and agreements established through the care planning process.
Provide the member and/or member's representative/guardian with flexible, innovative, and creative service delivery options.
Integrate access and referrals to Non-ALTCS services available through the community.
Work cooperatively and collaborate with SCAN staff, with physicians, discharge planners, utilization management, home health agency, community agency staff, and other professionals/paraprofessionals involved in the care of the member, and with the family to assure provision of high quality cost effective services.
Educate and help the member, member's representative/guardian to identify their role in interacting with the service system.
Educate the member, member's representative/guardian on how to report unplanned gaps. Develop written contingency or back-up plan for those members receiving critical services in their own home:
a) Attendant Care
b) Personal Care
c) Homemaker and/or d) In-home Respite
Obtain commitment from servicing provider(s),and authorize services as appropriate.
Provide necessary information to Providers about any changes in member's functioning to assist the provider in planning, delivering, and monitoring services
Perform other duties, assignments and responsibilities as assigned or required to meet the needs/goals of SCAN Health Plan.

Requirements

QUALIFICATIONS:

Requires Bachelor's degree (Master's preferred) social worker, licensed registered nurse, or licensed practical nurse, or health care professional that has a minimum of two years Case Management experience serving persons who are elderly and/or persons with physical or developmental disabilities.

Qualified candidates will have knowledge of Medicare and Dual Eligible criteria, medical terminology, and excellent assessment/interview skills desirable.

Requires travel within the state.

SCAN is an Equal Opportunity Employer