Job Description

Job Description

Job Description

Community Health Care Manager - Loveland, CO

Community Health Care Managers (CHCM’s) work with members enrolled in Medicaid to coordinate care and to connect them with essential community resources through partnerships with local physical and behavioral health providers. CHCM’s aim to enhance individual health outcomes and the overall healthcare experience by identifying each person's health and wellness goals and improving their ability to navigate the healthcare system while also working to reduce high healthcare utilization costs. The CHCM reports to the CHCM Supervisor.

Knowledge / Skills / Abilities

• Skills to communicate and interact appropriately and respectfully across multi-cultural differences.
• Strong critical thinking and problem solving abilities.
• Strong verbal communication skills (both over the phone and in-person).
• Basic Business writing skills.
• Strong customer service skills.
• Ability to multi-task, prioritize, and ability to handle multiple priorities while meeting deadlines.
• Computer skills including Microsoft Office (Outlook/Excel/Word), state administered data collec
• Experience working with EMRs preferred.
• Experience partnering with local and regional health and human service resources preferred (not required).
• Experience working with Medicaid and Medicare preferred (not required).
• Ability to effectively engage and build rapport in a variety of medical, behavioral health, justice involved, substance use, and homeless situations.
• Strict Confidentiality required.
• Bilingual preferred (not required).
• Reliable transportation and a valid driver license and insurance

Education or Formal Training

• HS Graduate or GED required

Licensure/Certifications

• Valid Colorado Driver License and Insurance required.

Work Environment Physical Requirements

• Annual Influenza vaccination required for all employees
• Frequent contact with the public by phone and in person
• Sitting for periods of time while utilizing a PC or laptop
• Standing for periods of time on uneven ground at times
• Walking for periods of time on uneven ground at times
• Climbing up and down stairs
• Bending and reaching
• Lifting up to 30 pounds
• May be exposed to weather elements such as heat, rain, snow, etc. during member engagements.
• Work in confined spaces within proximity to other staff, noise, and discussions

Job Responsibilities/ Essential Functions:

• Case Management and Care Coordination of assigned members
• Monitor members according to guidelines set by NCHA Policy and Procedure under the Care Management guidelines.
• Participate in home visits, telephone contacts, office/hospital visits, and other means of connecting with members to reach identified goals.
• Perform needs assessments and identify risk factors to develop person centered care plans.
• Assist members in scheduling appointments, follow-up care, referrals, medication refills, etc..
• Attend member appointments with providers and community resources as needed.
• Participate in health promotion and health education activities for members as identified in their health care plan.
• Facilitate collaboration, communication, and coordination among all members of an individual’s multidisciplinary healthcare team, while ensuring consistent and ongoing correspondence.
• Optimize member and family self-management through education, community resources, and support.
• Review appropriate cost-effective care and decrease duplication of services for members.
• Enter all documentation, contacts, and assessments into multiple databases with a high level of accuracy.
• Timely responsiveness to emails, calls, and requests.
• Review appropriate cost-effective care and decrease duplication of services for members.
• Understand, communicate, and facilitate member’s complaints, grievances, and appeal processes.
• Regular case reviews with supervisor.
• Strict confidentiality of member records and communications following HIPAA Law.
• Expected to develop competencies through ongoing education and professional development.
• Focus on meeting individuals “where they are at”.
• Support individuals in improving their understanding of how to access and use local resources for self-managing their health and wellness.
• Educate members on how to navigate the healthcare system.
• Able to work independently and in a busy office environment that may contain interruptions to work due to walk-ins, member needs, supervisor requests, phone conversations, etc.
• Able to manage stressful situations while remaining calm and non-reactive (i.e. working with members who may have severe and persistent mental health issues or substance use disorders)
• Able to utilize positive problem solving in difficult situations.

Other Duties as Assigned:

• Provide assistance as designated by Care Management leadership to support the overall goals and operational needs of NCHA, (such as on-the-job shadowing, staff relief, or other needs).
• Provide input into development of procedures and be accountable for adhering to them.
• Adhere to all programs designed to ensure due diligence in preventing, identifying, and reporting any unlawful or unethical behavior by colleagues, professional partners, or agents.
• Participation in ongoing performance improvement activities
• Provide oversight to students or guests wanting to learn about care management.
• Other duties as needed to meet demands of the organization (may include flexing or changing job location).

The above job definition information has been designed to indicate the general nature and level of work performed by employees within this classification. It is not designed to contain or be interpreted as a comprehensive inventory of all duties, responsibilities, and qualifications required of employees assigned to this job. Job duties and responsibilities are subject to change based on changing business needs and conditions.
The North Colorado Health Alliance was incorporated as a 501(c)(3) non-profit organization in 2002. The Alliance, based in the town of Evans in Colorado’s Weld County, is a creative and strategic collaboration of partner organizations that are dedicated to cultivating the health of the communities they serve.
At the Alliance, we recognize that health does not begin or end with medical, dental, and behavioral health services. Health also depends on features of the built environment and on a variety of social determinants that make it harder for many to resist the chronic illnesses of our times. Thinking globally, the Alliance acts locally and creatively to convene, integrate, and support community partners in our common effort to make northeastern Colorado the healthiest region in the healthiest state.

The North Colorado Health Alliance convenes partners and co-workers in education, community service, health care, business, faith-based organizations, and government. The Alliance’s mission is to see Northern Colorado become the healthiest region in the healthiest state by developing and supporting a healthy population with 100% access to quality service and care at a sustainable cost.

Company Description

The North Colorado Health Alliance convenes partners and co-workers in education, community service, health care, business, faith-based organizations, and government. The Alliance’s mission is to see Northern Colorado become the healthiest region in the healthiest state by developing and supporting a healthy population with 100% access to quality service and care at a sustainable cost.

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