Care Ally, Case Manager (Social Worker or LPN)
Company: AllyAlign Health
Location: Charlottesville
Posted on: January 25, 2023
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Job Description:
AllyAlign Health (AAH) is a leading convener and operator of
Medicare Advantage plans designed for senior living residents. The
company began work in 2014 by enabling leading long-term care
providers to launch provider-sponsored managed care plans for
vulnerable senior populations. Today, AAH manages special needs
plans that aim to reduce healthcare costs and improve patient
quality of life. AAH is now a proud member of the Curana Health
organization, where, together, a common mission seeks to expand the
reach and positive impact on senior living across the country. For
more information visitallyalign. com.
*Summary*
The Care Ally, Case Manager is a key member of the
interdisciplinary care team (ICT). They use a collaborative process
of assessment, planning, implementing, coordinating, monitoring,
and evaluating options and services required to meet the Member's
health and social needs.They act as a liaison between Members,
their Responsible Parties and/or Power of Attorneys (RP/POAs),
Advance Practice Providers (APP) and/or Primary Care Physicians
(PCP), and other key Align Senior Care stakeholders. The Care Ally,
Case Managerreports to the Supervisor of Case Management.
*Responsibilities*
* Executes strategies and goals set by the Align Senior Care Board
of Directors, the AllyAlign Senior Leadership Team, and the
Executive Director for managing and improving overall Member
experience.
* Contacts Plan Members to conduct a health risk assessment,
develop a plan of care, and participate in the Senior Housing
Community interdisciplinary care team meeting.
* Conducts face-to-face Member and/or caregiver visits a minimum of
quarterly if the Member is in a Long-term Care Facility and twice a
year for all other Members.
* Serves as a health coach to educate the Member, the family and/or
caregiver, about Plan benefits, community resources, and resource
options.
* Collaborates with Members of the interdisciplinary care team and
medical director(s) to facilitate appropriate treatment for
members.
* Communicates with the Member and/or caregiver to assist with the
development of health goals and identify interventions to achieve
these goals.
* Acts as front-line support with Members and their RP/POAs to
ensure the needs of the Member are met. Serves as a connection
point among Members, their Communities, their Care Team, and Align
Senior Care internal departments.
* Regularly engages Align Senior Care Members and RP/POAs in-person
or by phone to provide education and assistance with utilizing
Align Senior Care benefits. Including but not limited to checking
on upcoming specialist appointments, connecting members to
supplemental benefits and providers, identifying immediate Member
needs, and answering any questions the Member or RP/POA may
have.
* Communicates Member health updates from Care Team to RP/POAs.
* Coordinates with the Care Team for non-urgent health or clinical
questions.
* Works directly with AllyAlign's internal departments to solve
Member Grievances, Utilization Management, and Billing related
issues.
* Updates Member and RP/POA contact information such as changes of
address, email, or phone numbers.
* Assists with coordination of home health and therapy visits,
ordering of Durable Medical Equipment, and utilization of
supplemental benefits for Members.
* Monitors care plan updates, facilitates APP and PCP input into
care plan, and distributes care plan as needed to care team
members.
* Monitors midnight reports/community census to help identify
member transitions to hospital or other care levels.
*Education & Experience*
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* Undergraduate or graduate degree in social work (LSW), licensed
practical nurse (LPN), or have 5+ experience meeting the needs of
the aged, blinded, or disabled population
* 3-5 years of Case Management experience preferred
* Medicare or Medicaid knowledge preferred
* NCQA or URAC experience preferred
* Proficiency using basic computer skills in Microsoft Office such
as Word, Excel, and Outlook, including the ability to navigate
multiple systems and keyboarding.
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*Professional Certification Or Licenses*
Case Management certification preferred
*Due to the nature of our business, we require all of our employees
to be fully vaccinated against the COVID-19 virus on their first
day of employment, in compliance with CMS requirements and all
applicable EEOC guidance regarding vaccines and qualified
exemptions.*
Requirements:
Curana Health, LLC
Keywords: AllyAlign Health, Charlottesville , Care Ally, Case Manager (Social Worker or LPN), Executive , Charlottesville, Virginia
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