Insurance Case Manager Jobs in Colorado (NOW HIRING)

Case Manager

A&I Avenues is looking for a Case Manager to join our growing team. Case Managers provide Case Management to an assigned case load. They conduct eligibility determinations, develop and implement Service Plans, and provide information and resources to clients. Case Managers monitor quality of service delivery, and coordinate care planning with clients, families, guardians and providers Bilingual Case Managers maintain regulatory compliance; including ensuring documentation is completed to maintain ongoing funding for services for clients on case load.

Essential Duties/Responsibilities

Responsible for the development and implementation of the service plan.

• Completes face-to-face assessments to determine eligibility of client for long term care upon enrollment and annually.
• Leads annual review and development of the service plan for clients.
• Ensures service plan documentation is completed and distributed.
• Facilitates communication throughout the year regarding service plan and related services and supports.
• Monitors services each quarter (at minimum one face-to-face) to ensure quality and alignment with service plan goals.
• Coordinates delivery of services and supports.
• Educates clients, families, and guardians on appropriate service options and assists in acquiring needed services/supports.
• Coordinates the delivery of services and supports.
• Assists clients and families in resolving complaints with service providers and benefit sources. This may include a formal appeals process.
• Completes enrollments and terminations as needed; includes ensuring that proper notice of eligibility and discharge is provided.
• Connects clients with resources for crisis intervention as needed.
• For eligible waivers, ensures informed consent is acquired for Human Rights Committee related circumstances in accordance with the HRC process and recommendations.
• Ensures all required documentation for ongoing funding and benefits is in accordance with applicable Federal and State regulations and A&I Avenues policies and procedures.
• Completion of timely, accurate, professional documentation within established timelines.
• Completes any necessary follow-up to critical incidents and investigative reports.
• Provide case coverage in times of system change or staffing shortages.

Other Duties/Responsibilities

• This position requires regular use of a personal vehicle with liability insurance that meets A&I Avenues standards.
• This position requires regular use of a personal mobile device such as a smartphone or tablet.
• If position occupant has M.S.W., may supervise or assist in supervision of social work interns.

Job Qualifications

• Solid skills in working with people with disabilities.
• Independent judgment and discretion in monitoring, advising, and advocating for clients and their families.
• Person-centered, creative problem solving and strengths-based solution-finding.
• Ability to manage workload independently and prioritize tasks/goals to meet timelines.
• Ability to work effectively in a team setting.
• Effective and professional written and verbal communication skills with clients and groups at all professional levels.
• Strong planning, time management, and organizational skills.
• Ability to work efficiently with various technology including word processing software, e-mail, databases, and general internet skills.
• Possession of a valid driver's license and ability to meet A&I Avenues driving requirements.

Education:

• High School diploma required.
• Bachelor's Degree in human services related field is highly preferred.
• Five years' work/volunteer experience with long-term care and/or disabilities programs and services.
• Some combination of relevant education and experience appropriate to the requirements of the position.

Working Environment/Physical Activities:

• Effective with shifting roles, responsibilities, and expectations in a highly stressful and changing work environment.
• In the field workdays required regularly. Living arrangements on the Colorado front range strongly preferred.

Note: All internal candidates must be in good standing to qualify for this position. This job description is not intended to be an exhaustive list of all duties, responsibilities, or qualifications associated with the job. This is an hourly, non-exempt position, and all duties can be completed in a 40-hour work week. Overtime may not be worked without prior authorization and justification of work demands outside of published agency workflow-related time to task norms.

Benefits:

• 401(k) matching
• Dental insurance
• Employee assistance program
• Health insurance
• Life insurance
• Paid time off
• Paid training
• Vision insurance

Work Location: Hybrid remote in Lafayette, CO 80026