Track Case Manager

Licensed Nurse - Track Case Manager (Clinical Scheduler)

We are seeking a licensed nurse to fill our Track Case Manager (Clinical Scheduler) position to assist with all clinical scheduling needs for our patients. The Track Case Manager is responsible for overseeing and managing patient scheduling, care coordination, and follow-up for high-risk, acute, and transitional care patients within their assigned region. This role requires close monitoring of scheduling buckets, addressing urgent patient needs, and ensuring seamless communication between the care team, patients, and referral sources. The Track Case Manager will work a seven-day track schedule, providing comprehensive case management coverage and ensuring that patient care is aligned with Your Health's care model.

This position will be working in the Sumter or Florence office daily. This is a full-time, salary-based position.

We are a leading physician group serving South Carolina and Georgia, dedicated to delivering quality healthcare directly to patients in care facilities, homes, clinics, and virtual visits. Our services include comprehensive primary care, specialty services, and pharmacy support, tailored to meet diverse patient needs. Committed to excellence and innovation, our team collaborates closely with facilities and families to ensure accessible, coordinated, and compassionate care.

Providing high quality care for our patients is the center of what we do, and we provide the same care for our employees. Here are some of the benefits that are available to our employees.

• Competitive Compensation Package with Bonus Opportunities
• Employer Matched 401K
• Free Visit & Prescriptive Services with HDHP Insurance Plan
• Employer Matched HSA
• Generous PTO Package
• Career Development & Growth Opportunities

Your Health is currently looking for a Track Case Manager to join our growing Primary Care family. A successful Track Case Manager will be able to perform these essential duties and responsibilities. Reasonable accommodations may be made, in accordance with applicable law, to enable individuals with disabilities to perform the essential functions. The following is a list of essential functions, which may be subject to change at any time and without notice. Management may assign new duties, reassign existing duties, and/or eliminate function(s).

Areas of Responsibility:

• New Patient Triage: Evaluate and prioritize new patient referrals to determine appropriate service needs based on medical history, presenting conditions, and provide availability.
• Work closely with the care team to ensure patients are placed in the correct care pathway.
• High-Risk Patient Management: Review and manage care for high-risk patients, including scheduling appointments and follow-ups.
• Scheduling Buckets: Closely monitor and manage appropriate scheduling buckets, including region and transitional care management scheduling buckets
• Acute/Urgent Case Management: Address all new patient cases, acute/urgent requests, TCM patient cases, and other high-risk scenarios promptly.
• Track Partner Collaboration: Monitor and address tasks in the track partners bucket, ensuring no delays in patient care.
• New Patient Intake & Scheduling: Conduct initial screenings for new patients to assess care needs, verify eligibility, and coordinate timely scheduling.
• Ensure appropriate documentation and communication with providers regarding patient history, concerns, and special care requirements.
• Evaluate the patient to determine the most appropriate place of service for care, such as in-home services or clinic-based care, based on medical necessity, provider recommendations, and patient preference.
• Appointment Scheduling: Schedule patients promptly according to the Care Model, including TCM visits, acute cases, and follow-ups per frequency guidelines.
• Patient and Family Communication: Maintain strong communication, follow-up, and follow through with patients, families, and referral sources.
• Phone and Voicemail Management: Monitor incoming new patient calls during shift and promptly address voicemails by returning calls and ensuring the patient needs are promptly addressed.
• Assign follow-up calls to appropriate regional case management team members and monitor for timely completion.
• Insurance Verification: Prompt insurance verification when scheduling patients to ensure coverage and eligibility.
• Team Coordination: Collaborate with care teams, review care group chats, and attend required monthly meetings to ensure seamless operations.

Qualifications:

• A licensed nurse is required. Nursing license must be in good standing.
• A minimum of two (2) years of clinical experience is required.
• Previous experience in a medical or healthcare setting, preferably a scheduling or administrative role.
• Familiar with medical terminology, procedures, and insurance verification processes.
• Strong organizational and time management skills, with the ability to multitask and prioritize responsibilities effectively.
• Ability to read and communicate effectively.
• Strong written and verbal skills.
• Basic computer knowledge.
• Ability to manage and demonstrate effective leadership skills.
• Should demonstrate good interpersonal and communication skills under all conditions and circumstances.
• Ability to foster a cooperative work environment.
• Team player with ability to manage multiple responsibilities and demonstrate sound judgment.
• Must be able to work flexible hours and travel between offices, facilities, etc. Must be a licensed driver with an automobile that is insured in accordance with state and/or organizational requirements and is in good working order.