The individual performs care management to individuals of all ages who have been diagnosed with an IDD (Intellectual & Developmental Disabilities) /TBI (Traumatic Brain Injury), based on the DSM V or subsequent editions. The IDD Care Manager will complete Care Needs Screenings (CNS) as necessary and will be primarily responsible for completing the Comprehensive Assessment on eligible members who have IDD/TBI/LTSS needs. The IDD Care Manager will be primarily responsible for assisting the member develop their care team and the completion of the Care Plan/ISP based on the needs and desires of the member/legally responsible person, team and their support system. Plans will be person centered in nature and reflect all the areas of support needed by the member. The IDD Care Manager will ensure level of care assessments are completed and is responsible for coordinating the member’s whole person care (Physical, Behavioral, pharmacy—BH, IDD, TBI, and Unmet Social or Health-Related Resource Needs, including but not limited to vocational, education, social supports, personal safety, housing and food insecurity).
- and trouble shoots until authorization (if applicable) is obtained. Notifies care team as appropriate of successful authorization or service initiation.
Contacts are with patients, families, hospital personnel, job sites, schools, and community agencies. The care manager must guide a multidisciplinary team. Contacts with patients, families, and agency personnel are to exchange, provide, and obtain information concerning the individual’s physical and psychosocial health care problems, and needs.
The care manager uses teaching and counseling methods to influence and motivate patient and family behavior. Contacts with other health care or related disciplines within the hospital are for the purpose of collaboration and consultation. Tact, courtesy, and professional conduct are required to maintain positive working relationships. Utmost sensitivity and confidentiality is required when dealing with the individual and families.
The incumbent has access to highly confidential patient medical and personal information. The Privacy Act of 1974 mandates that the incumbent shall maintain complete confidentiality of all administrative, medical, and all other pertinent information that comes to his/her attention or knowledge. Adherence to HIPAA is mandatory. The Act carries both civil and criminal penalties for unlawful disclosure of records. Violations of such confidentiality shall be cause for adverse action.
The individual has a positive effect upon the wellbeing of the individual and is responsible for following policies and procedures, which serve as agency guidelines and prevents errors from occurring. Errors can have a negative outcome since the care manager’s performance affects the health, wellbeing, and habilitation of individuals, and
the quality of care provided. Evaluations and observations are used to modify and develop clinically, programmatic appropriate treatment and support plans. Work can be verified or checked by the immediate supervisor, other health care/habilitation providers or systems checks, but usually the responsibility for accuracy relies solely on the care manager.
While in the the primary care/care management office, the work is mostly sedentary, yet requires walking, standing, bending, pushing, and lifting, assisting individuals if needed to transport or change positions of individuals to and from beds, and wheelchairs. These same activities are required in moving equipment and medical supplies on behalf of the individual. The Care manager will be subject to frequent interruptions requiring varied responses, which can cause distractions therefore, the care manager must possess the ability to differentiate and prioritize many tasks at once while not loosing focus on task completion.
The care manager is required to travel to locations of provider services to observe the individual in their place of activity. This includes home, community settings or provider agencies. While observing, the care manager is constantly gathering information about the participation, progress or challenges for updating and documenting in progress notes or care plans.
It is expected that the care manager will be able to demonstrate the ability to be a self- starter, work with limited direct supervision and be aware of community-based programs and resources necessary to support the member in the IDD community in the area as well as across the State. This individual also needs to understand when they require supervision/support from their supervisor and reach out to get those needs met in a timely manner, seeking case consultation as necessary.
Must be flexible in working hours. Work is performed in the home setting, within the community and the office/clinic setting. While in the hospital/clinic setting which is responsible for treating patients with a wide variety of medical problems. Incumbent may be exposed to communicable diseases. The care manager is required to comply with Employee Health Program guidelines including current immunization status of identified communicable diseases and safety precautions are sometimes necessary, such as use of personal protective equipment as required by hospital policy. The work environment involves moderate risks of exposure to infectious disease, radiation, electrical hazards, irritant chemicals and explosive gases. Due to the need to make home visits, the care manager may be visiting homes that have the need for environmental upgrades and the amelioration of mold, eradication of pest, etc.
Consistently demonstrates superior customer service skills to patients/customers/members by demonstrating characteristics that align with CIHA’s guiding principles and core values.
Ensure excellent customer service is provided to all patients/customers/members by seeking out opportunities to be of service.