Apply online at http://www.alohacare.org/Careers/Default.aspx
The Company:
AlohaCare is a local, non-profit health plan serving Hawai`i’s low-income residents with free Medicaid and dual Medicare health insurance coverage. Our members include children, seniors, and adults residing on all islands. We provide comprehensive benefits and managed care services with an emphasis on healthy living habits and preventive primary health care. Our approach is to meet the whole-person health and social needs of members. Through our community partnerships we offer innovative services such as connection to social service agencies, Native Hawaiian healing services and in-home primary care for qualified members. Our mission is to serve in the true spirit of aloha by ensuring and advocating for access to quality health care for all. We are Hawaii’s third-largest health plan and offer a wide network of quality primary care, specialists, hospitals, pharmacies and among many other providers across the state.
The Culture:
AlohaCare employees have a passion for helping Hawai`i’s most underserved communities. Our caring culture is fundamental to our company-wide team approach to providing high quality services. We support our employees with a supportive and positive work environment, healthy work-life balance, continuous communication, and a generous benefits package.
AlohaCare’s leadership empowers and engages its employees by recognizing outstanding job performance and collaboration. We share organization-wide updates during quarterly All Staff meetings. We encourage participation in volunteer and educational opportunities. We put a high value on honesty, respect, and trust-building. We encourage open-door, two-way, and frequent communication.
AlohaCare’s comprehensive benefits package includes low-cost medical, dental, drug and vision insurance, paid time-off, 401k employer contribution, referral bonus and pretax transportation and parking program.
The Opportunity:
The Psychiatric RN Coordinator coordinates, monitors, and ensures that appropriate and timely mental health, acute and long-term care services are provided to members across the continuum of care. Assists in coordinating services inclusive of community services to the members. Promotes effective healthcare utilization, monitors health care resources and assumes a leadership role within the Interdisciplinary Care Team (ICT) to achieve optimal clinical and resource outcomes. Takes the lead of the care coordination team on all islands, assuring MD orders for medication administration are performed as ordered, and develops educational material for the care coordination team to utilize. Works with the management team of CCS to assess, plan, implement, coordinate, monitor, and evaluate services and outcomes to maximize the health of the Member. Assists CCS psychiatrist as needed by calling in prescriptions, assisting to locate members, assessing members when required and other duties as needed.
Primary Duties and Responsibilities:
- Conduct face-to-face visits with CCS members for the purpose of assessments, teaching, reviewing and administering ordered medications.
- Develop and provide training to agencies, community partners and staff regarding behavioral health and medical health integration as well as clinical.
- Order and administer medication as directed by the CCS psychiatrist and coordinates the ordering and administering of medications by other RN case managers.
- Interact with members, families, physicians, and other providers utilizing clinical knowledge and expertise to determine medical history and current status and to assess the options for care including use of benefits and community resources to update the Care Plan.
- Coordinate community resources and coordinates benefits, regulations, laws and public entitlement programs.
- Maintain HIPAA standards and confidentiality of protected health information; and reports critical incidents and information regarding quality-of-care issues.
- Utilize compiled data received from member electronic records to assure that the services being provided meet the members’ needs.
- Facilitate member and provider authorization and access to services.
- Seek to resolve any concerns about care delivery or providers.
- Develop and provides education to staff, community partners and agencies and clinical care for medical conditions such as Hypertension, diabetic care and dressing changes.
- Develop and provide education to staff, community partners and agencies regarding medications.
- Develop and provide community educational sessions for people with SMI, family of those with SMI and community partners who work with those who may have SMI.
- Participate in IDT meetings.
- Act as liaison and member advocate between the member/family, physician and facilities/agencies.
- Maintain accurate records of case management activities in the system using clinical guidelines.
- Ensure compliance with all state and federal regulations and guidelines.
- All other duties assigned.
- Adhere to regulatory compliance and quality guidelines as well as AlohaCare policies and procedures.
- Responsible for maintaining AlohaCare’s confidential information in accordance with AlohaCare policies, state and federal laws, rules and regulations regarding confidentiality. Employees have access to AlohaCare data based on the data classification assigned to this job title.
Requirements:
- High school diploma or equivalent.
- Minimum of 5 years of experience in relevant healthcare with client care coordination responsibilities in Behavior health.
- Licensed RN in the State of Hawaii.
- Minimum of 1 year of experience in working with a Severely Mentally Ill (SMI) population.
- Achieves results, builds trust, communicate effectively, customer and quality focused.
- Strong interpersonal and facilitation skills with the ability to communicate with all levels of the organization.
- Strong, effective, and precise written and oral communication skills; speak clearly and persuasively in positive or negative situations.
- Professional telephonic etiquette skills.
- Ability to solve problems, analyze, think critically, and make good judgments.
- Strong customer service skills and be able to work in a diverse, demanding and evolving environment with strong conflict and problem resolution skills.
- Able to work independently with minimal supervision.
- Able to effectively work in a fast-paced and changing environment, manage multiple projects and priorities across multiple teams/projects and in a matrixed environment.
- Possesses excellent time management and organizational skills; dependable, enthusiastic, self-starting, and self-motivated. Uses time effectively, reacts professionally under pressure.
- Data entry experience with a high degree of accuracy and attention to detail.
Preferred Requirements:
- Bachelor’s or master’s degree or related field or equivalent combination of education and experience.
- Certified Case Manager (CCM).
- Minimum of 1 year of experience in current case management as a licensed professional.
- Experience in a managed care environment.
Mental, Physical and Environmental Demands:
Salary Range: $65,000 - $83,000 annually
AlohaCare is committed to providing equal employment opportunities to all applicants in accordance with sound practices and federal and state laws. Our policy prohibits discrimination and harassment because of race, color, religion, sex (including gender identity or expression), pregnancy, age, national origin, ancestry, marital status, arrest and court record, disability, genetic information, sexual orientation, domestic or sexual violence victim status, credit history, citizenship status, military/veteran status, or other characteristics protected under applicable state and federal laws, regulations, and/or executive orders.