Southern California Permanente Medical Group (Kaiser Permanente)
Bakersfield, California
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Community Health Choice, Inc. (Community) is a non-profit managed care organization (MCO), licensed by the Texas Department of Insurance. Through its network of more than 10,000 providers and 94 hospitals, Community serves over 400,000 Members with the following programs:
' Medicaid State of Texas Access Reform (STAR) program for low-income children and pregnant women
' Children's Health Insurance Program (CHIP) for the children of low-income parents, which includes CHIP Perinatal benefits for unborn children of pregnant women who do not qualify for Medicaid STAR
' Health Insurance Marketplace Plans that offer individual health coverage that includes preventive care, emergency services, prescription drugs, and hospitalization available to all, regardless of pre-existing conditions.
' Community Health Choice (HMO D-SNP), a Medicare Advantage Dual Special Needs plan for people with both Medicare and Medicaid that combines Medicare Part A and Part B benefits, Medicare Part D prescription drug coverage, and Medicaid benefits with additional health benefits like dental, vision, transportation, and more.
Improving Members' experiences is at the heart of every Community position. We strive every day to make sure that our Members have access to the high-quality health care they need and deserve.
Community is accredited by URAC for its health plan operations. We offer care management programs for asthma, diabetes, and high-risk pregnancy. An affiliate of the Harris Health System (Harris Health), Community is financially self-sufficient and receives no financial support from Harris Health or from Harris County taxpayers.
JOB SUMMARY: Care Manager will manage Community Health Choice (Community) members with chronic disease and medically complicated needs through comprehensive evaluation and through coordination of Community resources. The Care Manager will participate as a team member in Community Care Management programs, which are designed to assist members with chronic diseases in self-management skills. Care Manager will work collaboratively with utilization review, member services and the quality improvement department.
MINIMUM QUALIFICATIONS: 1. Education/Specialized Training/Licensure: RN, current Texas License CCM required or must receive within 18 months of employment. 2. Work Experience (Years and Area): Three years of clinical experience 3. Software Operated: Microsoft Office (Word, Excel, Outlook).
SPECIAL REQUIREMENTS: (Check Applicable Areas) 1. Communication Skills: Above Average Verbal (Heavy Public Contact) Writing /Composing: Correspondence / Reports 2. Other Skills: Analytical, Medical Terminology, Research, MS Word, MS Excel
At Harris Health, we champion better health for our patients, their families and our community, by connecting all to an integrated healthcare system that provides high-quality healthcare. Harris Health focuses on the delivery of primary care, wellness and prevention services to the residents of Harris County, Texas, through its extensive network of 38 inpatient and outpatient facilities. Harris Health is staffed by physician faculty and residents from nationally ranked medical schools, Baylor College of Medicine, McGovern Medical School at The University of Texas Health Science Center at Houston (UTHealth) and M.D. Anderson Cancer Center.