Care Manager

Talent Operations Manager | Creative Solutions and Strategies for Growth and Excellence

Job Responsibilities

Daily review of hospital and skilled nursing home inpatient lists.

Submit case review forms to UM / Quality Department by 4:00 PM for new admissions.

Obtain daily updates from hospital and/or SNH case managers.

Provide information to hospital and/or SNH case managers as needed.

Coordinate patient admissions and office follow-up services.

Obtain medical records from hospital and/or SNH for office follow-up.

Assess family dynamics and support systems.

Coordinate with PCP and care team regarding admissions and ER diversions to skilled nursing facilities.

Notify SNH admitting physicians and case managers of admissions and provide medical information.

Maintain documentation in EMR and other case management software.

Contact high-risk patients who no-show, document reasons, and reschedule.

Interact regularly with the office care team to review procedures.

Review pre-op clearances with office staff.

Notify UM/Quality Department of upcoming inpatient procedures.

Monitor out-of-area admissions and report daily.

Notify Medical Economics/Data Department of all out-of-area admissions.

Review daily office schedules for case management interventions.

Manage recent hospital/SNH discharges and disease management.

Educate patients on advanced directives and community services.

Maintain current patient information and tracking systems for admissions and disease management.

Identify patients for disease management follow-up, including CAD/CHF/COPD/DM/CKD.

Conduct new patient orientation within the first month of enrollment, including assessments like Mini Mental, ADLs, and psychosocial evaluations.

Identify transfer for cause members or reallocation cases and maintain monthly logs.

Job Qualifications

Current Registered Nurse license.

Work towards and maintain case management certification.

Maintain continuing education relevant to case management and licensure.

CPR/BLS certification.

Benefits

Comprehensive benefits including health, vision, dental, and life insurances.

FSA and Employee Assistance Program (EAP).

401(k) retirement plan.

Health advocacy, travel assistance, and My Secure Advantage services.

PTO accrual and holidays.

Additional Information

Seniority level: Mid-Senior level

Employment type: Full-time

Job function: Healthcare Provider

Industries: Hospitals and Healthcare

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