Care Manager (Ohio)

Job Description

The Community Based Care Coordinator is responsible for coordinating care for individuals who are dual eligible for Medicare and Medicaid. This is a mobile, community-based position focused on engaging members with complex medical, behavioral, and social needs and connecting them with the appropriate healthcare providers, benefits, and community resources. The Care Coordinator will complete comprehensive assessments, develop individualized care plans, collaborate with interdisciplinary care teams, monitor member progress, and help ensure continuity of care.

Main Day-to-Day Responsibilities

• Meet with members in community-based settings, including member homes, offices, and other public/community locations.

• Conduct comprehensive assessments to identify members' medical, behavioral health, mental health, and social needs.

• Develop and maintain individualized care plans based on each member's needs.

• Coordinate care between members, physicians, specialists, healthcare providers, community organizations, and other service providers.

• Help members access community resources such as: o Housing o Transportation o Food assistance o Social services

• Educate members on their Medicare and Medicaid benefits and available services.

• Educate members and families on chronic condition management, medication adherence, preventive care, and healthy lifestyle choices.

• Follow up after hospitalizations or significant health events to support continuity of care and help prevent readmissions.

• Regularly monitor member progress and update care plans as needs change.

• Participate in interdisciplinary care team meetings and communicate barriers or changes in a member's care.

• Maintain accurate documentation of member interactions, assessments, care plans, and outcomes.

• Advocate for members and help them actively participate in healthcare decisions.

• Travel regularly for member, provider, and community-based visits.

• Manage multiple members/cases and changing priorities.

Skills and Requirements

• Ohio RN License

• Nursing degree from an accredited nursing program, OR Bachelor's degree in a healthcare field, OR Equivalent relevant work experience may be accepted in lieu of the required education.

• Experience in one of the following: o Nursing o Social work o Counseling o Discharge planning o Case management o Care coordination o Home/community health management

• Candidate must have: o Valid driver's license o Vehicle o Verifiable auto insurance o Ability to pass a driver's license record check

• Medicare and/or Medicaid managed care experience

• Experience working with dual-eligible Medicare/Medicaid populations

• Case Management Certification

• Understanding of community resources available to Medicare/Medicaid members

• Experience conducting member assessments

• Experience creating and managing individualized care plans

We are a company committed to creating diverse and inclusive environments where people can bring their full, authentic selves to work every day. We are an equal employment opportunity/affirmative action employer that believes everyone matters. Qualified candidates will receive consideration for employment without regard to race, color, ethnicity, religion, sex (including pregnancy), sexual orientation, gender identity and expression, marital status, national origin, ancestry, genetic factors, age, disability, protected veteran status, military or uniformed service member status, or any other status or characteristic protected by applicable laws, regulations, and ordinances. If you need assistance and/or a reasonable accommodation due to a disability during the application or the recruiting process, please send a request to [email protected].