Community Health Plan of Washington

Perform telephonic case management for members with acute, chronic, and complex diabetes needs. Coordinate resources and collaborate with multidisciplinary teams to develop and implement personalized care plans to improve health outcomes.

Responsible for the operational delivery of case management and coordination programs for members with complex medical, behavioral, and social conditions. This includes performing telephonic and field-based assessments, creating individualized care plans, and collaborating with multidisciplinary teams to improve member quality of life.

The clinician conducts utilization review for medical or behavioral health requests against established guidelines and policies, identifying and coordinating high-quality, cost-effective alternatives for patient care. They ensure members have timely access to care, support transitions between care settings, and collaborate with the healthcare team to achieve optimal patient outcomes.

The Case Manager I performs telephonic case management for members with acute, chronic, and complex needs, advocating on their behalf and coordinating resources to achieve optimal functional levels. Responsibilities include assessing, evaluating, planning, implementing, and documenting care within the clinical database system, ensuring access to appropriate services and collaborating with multidisciplinary teams.

The Community Health Worker acts as a liaison between health/social services and the community to improve service access and quality, building capacity through outreach, education, counseling, and advocacy. Responsibilities include engaging participants for care management programs, providing community outreach like home visits, coordinating services, and documenting client progress for care managers and providers.