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JOB SUMMARY: The Medical Case Manager is responsible for providing medical case management and care coordination services to clients and families identified by the Cuyahoga County Division of Child and Family Services (CCDCFS). Utilizing a holistic approach to case management, the Medical Case Manager administers the full scope of Medical Case Management Services utilizing the highest standards of practice, comprehensive organizational communication, and care coordination. Further, using a collaborative process of assessment, planning, facilitation, care coordination, education, evaluation, medical treatment, and advocacy, the Medical Case Manager will ensure that children referred by CCDCFS are preserved in their placement, children and families demonstrate an increase in overall understanding of medical diagnoses, there are fewer incidents of maltreatment, and out-of-home placements are minimized.

ESSENTIAL DUTIES:

+ Address all needs of the child and family, including medical, psychosocial, and behavioral, using a client-centered, collaborative, comprehensive, holistic approach.

+ Employ full cultural competency and awareness when interfacing with the child and family, respecting diversity and cultural tradition.

+ Use a spirit of collaboration to move children and their families towards self-sufficiency whenever possible and appropriate via advocacy, shared decision-making, and education.

+ Ensure the child and family are involved in all decision-making that will impact their lives with respect to their health and wellness. Advocate for and maintain the needs of the youth as the highest priority.

+ Minimize fragmentation of care whenever possible and work to achieve seamless and timely transition of care. Link families with community resources.

+ Coordinate care that provides positive outcomes – and measure those outcomes, ensure client satisfaction, and move clients to optimal level of health and well-being.

+ Improve adherence to the plan of care including medication adherence where possible and appropriate.

+ Engage parents/caregivers and youth in case management services, home health care services, medical appointments, and team meetings, including educational component related to presenting medical condition.

+ Seamlessly and in a timely fashion coordinate care across the behavioral and physical healthcare domains as well as ensure linkages with community-based resources for families.

+ Monitor the provision and quality of services provided to the child and family and act as liaison when new services/resources need to be sought or developed.

+ Employ evidence-based guidelines in daily practice.

+ Provide an initial assessment that will include strengths, identified goals and needs (including diagnosis if available) of all families related to medical concerns and involvement with CCDCFS. Assessment criteria may include, but not be limited to: physical/functional, medical history, psychosocial/behavioral, mental health, cognitive functioning, youth and family’s strength and abilities, cultural, linguistic, and spiritual contexts, health insurance status, history of abuse, violence or trauma, health literacy of the youth and family and capacity for self-care, transportation, readiness to change for the better, and other factors.

+ Develop an Individual Service Plan (ISP) based on initial assessment and collaboration with family, referent, health care providers, and other community partners.

+ Where appropriate, develop a plan for necessary mental health treatment services.

+ Contribute to the development and maintenance of the client record through timely completion of assigned documentation in accordance with applicable licensing and accreditation regulations and standards.

+ Maintain and update progress notes documenting services provided, duration of service, progress toward goals, next steps, and additional recommendations and share these reports with CCDCFS staff at regular intervals and upon request from CCDCFS.

+ Provide monthly statistical reports including, but not limited to, number of referrals, hours of billable (Medicaid/insurance) and non-billable services provided (including face-to-face contacts, and cases terminated.

+ Provide the following information per the termination summary to all youth and families and all relevant stakeholders: goals of treatment, progress towards treatment, evidence of goal completion and/or family’s increased functioning and ability to manage medical concerns within the home, additional linkages, and provision of medical information and a unique crisis plan specific to the diagnosis/medical concern in order to manage matters independent from the provider/county.

+ Provide bi-weekly availability/capacity on request to CCDCFS.

+ Ensure a minimum of three (3) face-to-face contacts per month with each youth and family.

+ Attend at least one (1) health care appointment per month for all referred youth.

+ Attend team conferences/meetings regarding case progress.

+ Ensure the provision of after-hours/emergency on-call services.

+ Ensure the transportation is not a major barrier to the families staying involved with the service(s) provided.

OTHER DUTIES:

+ Attend scheduled staff meetings, supervision, and on-going training.

+ All required trainings, certifications and licensure must be kept current in accordance with applicable licensing and accreditation regulations and standards.

+ Maintain high standards of ethical and professional conduct and adhere to Agency policies and procedures.

+ Other duties as assigned by management.

QUALIFICATIONS:

+ Education:  Bachelor's Degree in Social Work, Psych or related mental health field.

+ Licensure:  Valid Ohio LSW or LPC required.

+ Competency/Skills:

+ Strong clinical skills including expertise in Case Management.

+ Core Expertise: Possess skill, knowledge and abilities to perform the essential duties of their role; keeps knowledge up to date.

+ Independent Judgment: Demonstrate ability to perform job responsibilities with a high degree of initiative and independent judgment.

+ Cultural Competency: Demonstrate awareness, sensitivity and skills in working professionally with diverse individuals, groups and communities who represent various cultural and personal background and characteristics.

+ Interpersonal Communication: Communicate clearly using verbal, nonverbal, and written skills in a professional context; demonstrates clear understanding and use of professional language.

+ Professional & Ethical Conduct: Adhere to professional values such as honesty, personal responsibility, and accountability; Applies ethical concepts within scope of work and adheres to Agency policies and procedures.

+ Collaboration and Teamwork: Function effectively as a member of a professional team that includes employees, clients and family members.

+ Problem Solving & Decision Making: Recognize problems and responds appropriately; gathers information and sorts through it to identify and address root cause issues; makes timely decisions.

+ Service Orientation: Anticipate, recognize, and meet the needs of others, whether they are clients or not.

+ Technical Proficiency: Demonstrate competence in utilizing Agency computer systems and software as required to perform essential job functions.

Experience: A minimum of 2 years experience in mental health required. Experience working with children, adolescents, and families.

Bellefaire JCB is an equal opportunity employer, and hires its employees without consideration to race, religion, creed, color, national origin, age, gender, sexual orientation, marital status, veteran status or disability or any other status protected by federal, state or local law.

Bellefaire JCB is a partner agency of the Wingspan Care Group, a non-profit administrative service organization providing a united, community-based network of services so member agencies can focus on mission-related goals and operate in a more cost-effective and efficient manner.

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