Medical Case Manager

This position is in support of the Influx Care Facility located in Carrizo Springs, TX.  The purpose of the facility is to provide comprehensive care for migrant youths ages 13 to 17 in the Care of the Office of Refugee Resettlement (ORR) who are awaiting reunification or repatriation.  This care will begin as soon as the youths arrive at the facility and last until their arranged departure with family or sponsors. The comprehensive care includes but is not limited to initial screening and exams, identifications of prior conditions and allergies, day to day care of routine, urgent and emergency medical conditions. The Medical Case Manager (MCM) will coordinate all onsite medical cases to ensure that appropriate and timely medical services are provided. This task will be achieved through liaising with local healthcare providers to identify the appropriate care, service, and location to manage the healthcare needs of patients and families.  The MCM will assure a comprehensive and effective Case Management process in support of patients to ensure functional care pathways are created. Case Pathways must promote effective communication with the medical care team in the identification of individuals requiring Case Management and the utilization of opportunities within the local healthcare system. The Lead MCM will utilize and maintain an approved data collection system in support of the program to demonstrate an effective end-to-end case management process.   Key ResponsibilitiesEstablish and operate a new case management program that bridges the gap between the complex healthcare needs of the patients.  Ensure appropriate oversight and direction for cases allocated to their respective teams. Facilitate the capacity and capabilities within the Onsite Medical Teams and the requirement for care within the local health care system.   Responsible for the tracking, trending, and reporting of managed cases to support the defined reporting requirements of the client. Coordinate patient care throughout the healthcare continuum.  Collaborate with social services to define patient’s needs and assist in plans for social service care.  Reassess patient needs based on current evaluation of patient care.  Serve as an advocate for the patient within the internal and external healthcare system.   Serve as 24/7 POC for local hospitals to provide clinical instructions/discharge instructions.  Communicate with clinicians' regarding treatment requirements, such as medications, etc.  Coordinate with evacuation services for patient pick-up from local hospital.  Coordinate and verify insurance eligibility and coverage for specified care with receiving facilities.  Provide patient education on benefits, services, and other resources.  Facilitate communication with patients, providers, and payers to secure successful outcomes.  Ensure a comprehensive system to evaluate the healthcare needs of the individual and/ or family to facilitate their overall wellness and one that addresses health issues to enhance the short and long-term outcomes.  Ensure input from the Quality Assurance and Medical Team/s is collated for reviews and revisions.    Participate in Interdisciplinary Team Meetings as required with the onsite medical leadership.  Maintain accurate case management documentation in accordance with HIPAAA, and other local laws pertaining to confidentiality.  Responsible for the creation and maintenance of a Case Management Standard Operating Procedure (SOP) IAW with client requirements.