Integrated Care Manager (44428)

The Integrated Care Manager (ICM) works collaboratively with the integrated care team to manage and coordinate care for a specific population of members whose needs represent high clinical and social risk in order to ensure quality and cost-effective member-centered care.

Duties and Responsibilities

Responsibilities include, but are not limited to the following:

• Practice care management within the scope of licensure.
• Utilizes care management principles and sound clinical judgment in coordinating care for a specific member population
• Performs intensive care management functions for identified individuals in order to promote quality, cost-effective outcomes, including but not limited to:
• Performing a comprehensive assessment which includes care planning activities including the development of interventions, short and long-term goals in collaboration with member, family, PCP, behavioral health professionals and other involved health care professionals and community agencies, as appropriate
• Communicate with providers to facilitate needed care
• Implements care plan, facilitates referrals, coordinates services, and resources and provides ongoing monitoring and re-evaluation of outcomes
• Continuous monitoring and evaluation of the care outcomes and identification of service gaps
• Regular review and revision of the plan of care in collaboration with the family and appropriate members of the health care team based on the outcomes and evaluative findings
• Off-site visits (such as but not limited to home, hospital or community health centers or other community agencies) as necessary or required
• Completes comprehensive documentation of all activities and contacts in Care Management software system
• Facilitates referrals and coordinates needed services
• Collaborates with team as necessary in identifying needed services and supports
• Communicates with ancillary departments, such as Provider Relations and Member Services, as necessary to meet individual needs of members and providers
• Meets department and regulatory standards for accuracy, proficiency, and documentation in order to communicate decisions and plan of care in an appropriate and timely manner
• Provides clinical oversight to community outreach and other team members, providing direct supervision of community outreach staff as appropriate regarding individual care status
• Serves as a clinical resource to respond to questions from various departments
• Provides cross-coverage as assigned
• Participates in outreach/marketing activities as needed and as appropriate
• Other duties as assigned