Care Management Staff and WICT Qualifications Sample Clauses

Care Management Staff and WICT Qualifications. In order to respond to the unique needs of SSI members, the HMO must employ, or contract for the employment of, licensed healthcare professionals and other qualified care management staff with the following skills and knowledge needed to coordinate care for members (upon hiring or incorporated into their annual training plan): Motivational interviewing skills Patient engagement strategies Knowledge of the target population Knowledge and experience with trauma informed care and the stages of change approach An understanding of the impact of social determinants (e.g., poverty, lack of food or social supports) on health. Care Management Staff Training Plan HMOs must submit to the Department for review and approval a Care Management Staff Training Plan upon Department’s request. The training plan must demonstrate how the HMO ensures staff are appropriately trained and supported to provide care management services to members. Caseloads HMOs must allow care management staff and the WICT adequate time to effectively coordinate the delivery of integrated care. In order to do so, HMOs must have strategies in place to monitor care management team workloads and to assure that each team member is assigned a manageable caseload based on their roles and responsibilities within the team. HMOs must develop and maintain written caseload standards in consideration of the following: The complexity of the cases. The need for licensed health care professionals and other care management staff to coordinate with other providers and community resources. The need for in-person contacts with the member, providers, and others instrumental to meeting the needs of the member. Management duties, including providing direction to care management team members and ensuring adequate documentation of care management activities.