Sr Care Manager Atlanta

Sr Care Manager Atlanta (2603316)

POSITION SUMMARY

Screens appropriate referral and coordinates admission process. Coordinates services with providers, billing reconciliation. Provides outreach to community referral sources. ESSENTIAL JOB FUNCTIONS, DUTIES, AND RESPONSIBILITIES Markets area for awareness of SOURCE and PRN meetings with new PCPs. Completes all new admission paperwork for signed forms and in-home assessments. Participates in team meetings with Medical Director each week and presents all new admits, annual assessments, hospitalizations, Home Health admits and discharges, repeat variances, people with potential for discharge, actual discharges, and situations threatening a member’s health or functional status. Completes quarterly home visits and quarterly PCP visits with all required components. Completes variances when a care path goal is not met, lists a variance plan of action, follows up to resolution, or documents a repeat variance with a new plan. Tracks all hospital/ER visits by completing paperwork, requesting records, and communicating with hospitals. Coordinates with outpatient therapy centers, home health agencies, healthcare centers (if short term), and rehab by working with staff and completing the skilled care track form. Makes PRN contacts and home visits if needed to assess member needs. Reevaluates member needs for service level and evaluates service effectiveness. Uses own vehicle for travel, completes mileage and timesheets for reimbursement, arranges transportation as required, is available for internal record audits, completes annual reassessments in member homes, and reviews medication for appropriateness. Attends trainings when required, trains new hires as needed, is available for on‑call rotation as designated by CMS referrals, and communicates with regulatory and DFACS agencies for APS and CPS referrals.

QUALIFICATIONS

Must have a valid driver’s license and automobile insurance liability. Graduate of a state‑approved accredited nursing school. Certified in Basic Cardiopulmonary Resuscitation. Minimum of five (5) years of nursing experience. Hospice or SOURCE care preferred. EEO Statement As an Equal Employment Opportunity employer, all qualified applicants will receive consideration without regard to race, color, religion, sex, national origin, disability, or veteran status. For Florida Job Postings Only For more information regarding Florida’s Care Provider Background Screening Clearinghouse Education and Awareness, please visit #J-18808-Ljbffr PruittHealth