non-compliance with training by the Care Coordinators. The Care Coordinator must: Act as the single point of contact for an Enrollee to the Contractor and the ICT; Be a provider-based clinician or other trained professional; or Be an individual employed or contracted by the Contractor or the Enrollee’s Primary Care Provider who is trained in providing care coordination to persons with disabilities; As a member of the ICT, execute the following responsibilities: Participating in Comprehensive Assessments for care planning; Ensuring that ICT meetings and conference calls are held periodically; Monitoring the provision of services, including outcomes, assessing appropriate changes or additions to services, and making necessary referrals, as needed, for the Enrollee; and Ensuring that appropriate mechanisms are in place to receive Enrollee input, Complaints, and Grievances, and secure communication among relevant parties. 3. Clinical Care Manager For Enrollees with Complex Care Needs, as determined by the Contractor or a Provider under agreement with the Contractor to assume Clinical Care Management responsibilities, the Care Coordinator will be a Clinical Care Manager. In addition to executing the care coordination responsibilities in Section 2.5.C.2 the Clinical Care Manager will provide or as appropriate coordinate Clinical Care Management for medical and Behavioral Health Services. The Clinical Care Manager must be a licensed registered nurse or other individual licensed and/or certified to provide Clinical Care Management, employed by the Enrollee’s Contractor or Primary Care Provider, or patient-centered medical home or health home provider.
non-compliance with training by the Care Coordinators. The Care Coordinator must: Act as the single point of contact for an Enrollee to the Contractor and the ICT; Be a provider-based clinician or other trained professional; or Be an individual employed or contracted by the Contractor or the Enrollee’s Primary Care Provider who is trained in providing care coordination to persons with disabilities; As a member of the ICT, execute the following responsibilities: Participating in Comprehensive Assessments for care planning; Ensuring that ICT meetings and conference calls are held periodically; Monitoring the provision of services, including outcomes, assessing appropriate changes or additions to services, and making necessary referrals, as needed, for the Enrollee; and Ensuring that appropriate mechanisms are in place to receive Enrollee input, Complaints, and Grievances, and secure communication among relevant parties. 3. Clinical Care Manager For Enrollees with Complex Care Needs, as determined by the Contractor or a Provider under agreement with the Contractor to assume Clinical Care Management responsibilities, the Care Coordinator will be a Clinical Care Manager. In addition to executing the care coordination responsibilities in Section 2.5.C.2 the Clinical Care Manager will provide or as appropriate coordinate Clinical Care Management for medical and Behavioral Health Services. The Clinical Care Manager must be a licensed registered nurse or other individual licensed and/or certified to provide Clinical Care Management, employed by the Enrollee’s Contractor or Primary Care Provider, or patient-centered medical home or health home provider.