Hawaii Medical Service Association Case Manager - Service Coordinator - Dual Care (Oahu) in Hawaii

Company:Hawaii Medical Service Assn.Job Title:Case Manager - Service Coordinator - Dual Care (Oahu)Exempt or Non-Exempt:ExemptIsland:OahuCity:HonoluluLocation:KaimukiEmployment Type:Full TimeJob Summary:To provide case management services for eligible HMSA members and facilitate a collaborative relationship among members, providers, community agencies and HMSA staff in order to ensure members receive timely and integrated access to services across the continuum of care, including supporting and managing member’s physical, emotional, social and economic barriers to appropriate medical care.Mobile Office Environment: Position requires ability and allows the flexibility to work primarily from home or in a mobile office environment and to a lesser extent at various unassigned workstations located throughout applicable HMSA department(s) mainly for in-person meetings with internal contacts. Parking validation will be provided on an occasional and transitory basis for approved business needs.Duties and Responsibilities:

  • Conduct timely face to face health/functional/risk assessments and develop, document, and implement targeted service/care plans based on the results of the assessment for members requiring assistance with care coordination.

  • Coordinate a team of decision-makers to develop a service/care plan including the PCP, other providers as appropriate, the member, and others determined by the member including family members, caregivers, and significant others in order to ensure timely access to appropriate medical care.

  • Document and resolve issues for eligible HMSA members and providers on appropriate electronic systems.

  • Provide continuity of care when members are discharged from a hospital and help them with medication adherence and reconciliation.

  • Coordinate and monitor activities among internal departments, external community agencies including DHS, Medicare, and the DOH programs excluded from QUEST Integration, as well as HMSA partners/vendors.

  • Utilize compiled data received from member encounters to assure the services provided meet the member’s needs.

  • Assist Unit Manager in updating or establishing new policies and procedures as needed or identified.

  • Provide assistance in resolving any concerns about service delivery or providers.

  • Perform other duties as assigned.

Minimum Qualifications:

  • Must meet all State certification and licensure requirements for a social worker, licensed nurse, or other healthcare professional with a minimum of one year of related experience in care coordination or case management. A licensed “healthcare professional” is defined as a physician, podiatrist, optometrist, psychologist, dentist, physician assistant, physical or occupational therapist, speech-language pathologist, audiologist, registered or practical nurse, licensed clinical social worker, nurse practitioner, or any other licensed or certified professional who meets the State requirements of a health care professional.

  • Current, unrestricted RN, LPN, or social worker license issued by the state of Hawaii or any other license or certification that meets the State requirements of a health care professional.

  • Strong verbal and written communication skills.

  • Exhibit cultural sensitivity to people of various ethnic origins and socioeconomic backgrounds.

  • Ability to prioritize and manage multiple projects and assignments.

  • Ability to solve practical problems and deal with a variety of unique situations where only limited standardization exists.

  • Requires safely operating an insured automobile for travel to off-site locations to conduct and accomplish business related activities.

  • Must have valid driver’s license, access to an automobile with current license, registration and no fault insurance.

  • Must be willing to travel to neighbor islands and/or work occasional evenings and weekend hours/days.

EEO/AA/Disability/Vets Employer