Claims Processing Manager Jobs in Santa Rosa, CA

Join our team and make a difference in peoples lives!

We're looking for a Lead Care Manager for the Sonoma County area!

Job Specifics:

• Official Job Title: Lead Care Manager
• Job classification: Non-Exempt, 40 hours per week
• Job Location: Position will be working from both remote home office and field locations in the Sonoma County, CA area.
• Pay: $28.40 per hour

Our Philosophy

LifeSTEPS is committed to build thriving communities by empowering individuals and families through supportive housing and services. The STEP in LifeSTEPS stands for Skills Training and Educational Programs and is the heart of our mission. We believe community development is built One STEP at a time. Our vision is that every person served by LifeSTEPS will be empowered with the skills, resources, and support to maintain stable housing and break the cycle of poverty. Our founders believe that building affordable housing is only the first step. It is also essential to provide meaningful programs that empower people to move forward in their lives.

About us

LifeSTEPS, is a 501(c)(3) nonprofit charitable organization. It was founded in 1996 and currently has over 440 partnered affordable housing properties all over the state of California. We serve several regions from Sacramento, Bay Area, South Bay, Central Valley, LA County and Inland Pacific regions. We work with 115,000 residents all over the state and we’re on a mission to provide effective educational and supportive services to maximize the strengths of individuals and build resilient communities.

Our Benefits

In addition to meeting your passion for making a difference in the lives of those we serve, all employees will receive the following benefits:

• Competitive pay based on skill and experience
• Paid Holidays
• Paid Sick Leave
• Employee Assistance Program
• LifeSTEPS Perks Program

Benefit eligible employees working 30 hours per week or more will also receive:

• Medical, Dental Vision, and Life Insurance
• 401(k) plan
• Identity Theft Program
• Pet Insurance
• Paid Time Off

About the Position

The Lead Care Manager under the direction of the Cal AIM Services Director, assists and aids members with enhanced coordination of care.

Core Duties (but not limited to) Lead Care Manager:

• Promote and live out the LifeSTEPS workplace values of integrity, innovation, empowerment, respect and personal growth in tandem with the Oz Principles.
• Follow all LifeSTEPS policies, procedures and guidelines.
• Assess members to identify needs such as personal and family adjustments, finances, employment, food, clothing, housing, and physical and mental impairments to determine nature and degree of assistance.
• Responsible for developing and monitoring the member’s care plan.  Responsible for revising member’s care plan as needed.
• Coordinate with external entities providing member with some level of care.
• Coordinate with primary care providers, specialists, behavioral health, community based, long term services and supports needs and oral health providers involved in the care of the member.
• Medication review/reconciliation.
• Scheduling appointments and providing appointment reminders.
• Coordinating transportation and possible accompaniment to critical appointments.
• Identify and help to overcome barriers to adherence to care plan.
• Promote, coordinate and tailor services to meet identified needs.
• Assist members individually, with family, or guardians and caregivers regarding plans for meeting needs; provide culturally appropriate person centered planning, education, training and care instructions and document those activities and the plans for follow up.
• Advocate and refer members to community resources, human services and other organizations as needed.
• Compile records and prepare reports.
• Submit claims to Managed Care Plans (MCP’s) for all member services when required.
• Maintain all required client data in the mylifesteps.org database on a continuous, regular basis.  Ensure entries are up to date prior to each weekly supervision call.
• Complete all administrative assignments including timely data entry in multiple databases.
• Review service plan and perform follow ups to determine quantity and quality of services provided members and status of member cases.
• Access and record member and community resource information.
• Secure supplementary information such as employment, medical records, or school reports as needed.
• Study and assess strength and weakness of existing resources.
• Provides comprehensive housing transitions and housing tenancy navigation support to members eligible for services
• Completes screenings and assessments to identify housing needs and factors contributing to housing instability, including functional, environmental, employment, educational, and health information, as appropriate.  Identifies and facilitates access to suitable housing options for members, as well as application processes, move in activities, rental negotiations and service referrals. Conduct facility and habitability inspections, as needed.
• Facilitates access to supportive services such as job training, life skills development, legal services financial resources and health care providers.
• Fosters working relationships with property management firms, property owners, housing services agencies and housing advocacy organizations. Engage with landlords and familiarize them with LifeSTEPS housing services and community resources to assist in preventing and addressing tenant issues.
• Provide culturally appropriate health education information and outreach in community based settings, such as homes, clinics, shelters, local businesses, and community centers for various Managed Care Plan (MCP) members.

Education and/or Experience and/or License Certification:

• Bachelors degree in social work, psychology or related field.
• Two (2) years of experience in a similar environment providing social services.
• An equivalent combination of education and experience may substitute for the degree.

Are you ready to make a difference, stand behind and support individuals and families so they achieve their goals and become empowered to move forward in their lives? Apply today!!!

Please Note

LifeSTEPS values the diversity of the people it hires and serves. Diversity at LifeSTEPS means fostering a workplace in which individual differences are recognized, appreciated, respected, and responded to in ways that fully develop and utilize each person's talents and strengths. We are an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, gender, gender identity, sexual orientation, marital status, national origin, disability, age or covered veteran status. Please provide us with notice if you will require accommodations during the interview process.

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