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Community Based Clinical Coordinator – Care Manager
Upper Peninsula Health Plan (UPHP). Perform assigned clinical functions in accordance with UPHP plans, policies, procedures, and regulatory standards .
Core Competencies
Role fitCore Competencies
Use this summary to align your resume positioning with the role.
Demonstrates expertise in clinical assessment, care coordination, and individualized care planning while adhering to regulatory standards. Proficient in advocating for members' needs and collaborating with multidisciplinary teams to enhance health outcomes.
Highest-signal resume keywords
Licensed Registered NurseClinical Care CoordinationCare Management ExperienceExcellent Communication SkillsData Interpretation and Analysis
ATS Keywords
Tailor your resumeApplicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard Skills
Clinical AssessmentIndividualized Care PlanningResource UtilizationTreatment Plan DevelopmentRisk ManagementQuality ImprovementStatistical Data ReviewKeyboarding Proficiency
Soft Skills
Organizational AbilitiesPrioritization SkillsHuman Relation Skills
Tools & Technologies
MS Office WordMS Office ExcelMS Office AccessMS Office PowerPoint
Certifications & Qualifications
Michigan RN LicenseValid Driver's License
Industry Keywords
UPHP StandardsMDHHSCMSDIFSNCQAHEDISManaged Care
About the role
Key responsibilities & impact- Perform assigned clinical functions in accordance with UPHP plans, policies, procedures, and regulatory standards
- Assess, plan, and coordinate medical and supporting services across the continuum of care for selected members
- Conduct required frequent in-person visits with members in homes, nursing facilities, and other care settings
- Serve as the member’s single point of contact and gather health history
- Monitor home environment, community-based service access, and behavioral and health-related social needs
- Assess health status, resource utilization, treatment plans, prognosis, goals, and care options
- Develop individualized plans of care with objectives, goals, and interventions
- Monitor services and referrals to community organizations, medical care, and other providers
- Address member questions and unmet physical, behavioral, and health-related social needs
- Advocate for members and collaborate with care teams, providers, equipment companies, home health agencies, hospitals, and other parties
- Coordinate discharge plans, care plans, acute care, and long-term care services
- Identify and report risk-management and quality concerns
- Participate in departmental and interdepartmental process improvements
- Develop and maintain care-management policies and procedures
- Apply MDHHS, CMS, DIFS, NCQA, and HEDIS standards to clinical and care-management functions
- Provide backup support to other team members
- Attend organizational, departmental, interdisciplinary care team, and clinical program meetings
- Maintain confidentiality of client data
- Travel locally for home visits and periodically to UPHP headquarters in Marquette, Michigan
Requirements
What you’ll need- Minimum: Licensed registered nurse
- Must be licensed in the state of Michigan
- Minimum: Two (2) years of clinical or health-related experience as a licensed registered nurse or social worker
- Valid Driver’s License with proof of insurance
- Working vehicle required
- Keyboarding proficiency and working knowledge of MS Office Word and Excel
- Excellent human relation and oral/written communication
- Excellent organizational and prioritization abilities
- Candidates must reside in the Upper Peninsula of Michigan or be willing to relocate
- Must hold a current, active Michigan license corresponding to a qualifying credential: RN, LLBSW, LBSW, LLMSW, or LMSW
- Private home office required
- Ability to interpret and analyze data (desired)
- Working knowledge of MS Office Access and PowerPoint (desired)
- Preferred: Bachelor of Science in Nursing, limited licensed bachelor of social work, limited licensed master of social work, fully licensed bachelor of social work, or fully licensed master of social work
- Preferred: Two (2) years of clinical managed care experience or five (5) years of clinical experience as a licensed registered nurse or social worker; experience in care management; experience reviewing statistical data
- UPHP does not offer visa sponsorships or STEM OPT extensions for new applicants
Benefits
Comp & perks- Additional compensation potentially available based on qualifications
- Stipend provided for initial on-site/in-person onboarding and training
- Computer and phone hardware provided
- Mileage reimbursement provided at GSA rate