Senior Care Worker - Remote CA

This position can be available for remote or in-office, however, candidates must reside in CA.

This position locates services for patients and members with the goal of supporting the coordination of care such that members are able to access care in a timely manner and to remain in the least restrictive level of care appropriate to their functioning. Facilitates continuity of care as patients move through levels of care as authorized by clinical staff. Responsible for problem-solving and explaining company programs and procedures to clients and providers. May be assigned additional special responsibilities commensurate with experience and qualifications, such as TRF (Treatment Request Form) review, CISD (Critical Incident Stress Debriefing) assistance, clinical decision follow up support or other clinical support as needed. Will coach and precept new hires and less experienced staff in all elements of the role responsibilities as detailed below.

• Troubleshoots for the clinical team when an appropriate provider, type of service, or appropriate level of care cannot be readily found. 
• Links clients to appropriate services within the community. 
• Assists in discharge planning for hospitalized patients and makes appropriate placements as needed.
• Participates in the treatment team and assists in coordinating physical, psychological and/or psychiatric services for the patients.
• Provides information to members and providers regarding mental health, physical health and/or substance abuse benefits, community treatment resources, mental health managed care programs, and company policies and procedures.
• Assists in the adhoc process either in submitting adhocs as the designated adhoc Care Worker or assisting Care Managers in completing the form correctly and, in utilizing search features for securing credentialed providers for appointments as needed. 
• Assists in monitoring the CW/Gatekeeping queue during the supervisor’s absence. 
• Participates in quality activities, including data collection, tracking, and analysis.
• Assists efforts to continuously improve by assuming responsibility for identifying and bringing to the attention of responsible entities operations problems and/or inefficiencies with possible suggestions for more effective processes. 
• Leads or participates in activities as requested that improve Care Center/Health Plan performance, excellence and culture. 
• Supports team members and participates in team activities that build a high-performance team.
• Demonstrates flexibility in areas such as job duties and schedule in order to aid in better serving members and help the company achieve its business and operational goals. 
• Demonstrates proficiency, ability and willingness to perform all responsibilities including but not limited to, Ambulatory Follow Up, Account Specific Follow Up, Community Resource Requests and basic file room …