Complex Case Manager

Complex Care Manager

High Desert Medical Group is seeking a full time Complex Care Manager. Complex Case Manager is responsible for fostering a collaborative and professional relationship between Complex Case Management (CCM), patients, and High Desert Medical Group (HDMG) providers.

Summary of Duties:

• Identify complex case patients based on enrollment criteria.
• Manage/monitor patients, including but not limited to: daily/weekly phone calls, home visits and/or PCP office visits.
• Create and maintain working files/logs and/or tracking systems for each patient to ensure proper follow-through.
• Document appropriate and pertinent information in patient charts and q.Health (HMO and ACO).
• Follow up on patients by making necessary calls to patients/families/providers to optimize continuity of care and minimize resource utilization and hospitalizations.
• Utilize in-house, social service, health plan and community resources available to provide appropriate education and care delivery required to optimize patient health and welfare.
• Conduct home visits and/or make recommendations for support staff (RT, LCSW, Medical Provider) that provide home visits to facilitate needs that optimize patient care and safety.
• Communicate with provider and provider staff to ensure necessary required paperwork, e.g., lab/test results from hospital, etc., are available for review by provider before or at time of patient appointments.
• Attend CCM Forensic and staff meetings as requested.
• Communicate with physician/provider and nursing staff to ensure appointments are being kept.
• Coordinate with PSA appointment scheduler to ensure patients are being scheduled appropriately and in a timely manner.
• Assist in generating needed referrals for patients in order to expedite care, optimize health and/or prevent exacerbation of disease process. Document and ensure receipt of supplies and/or services ordered.
• Maintain a collaborative relation with the ancillary support departments to ensure patient education, materials and referrals for other avenues/efforts are completed to assist in patient adherence to treatment program.
• Function as liaison between in-patient and out-patient delivery systems to facilitate continuity of care.
• Develop and maintain current and relevant patient care plans, goals and interventions, assessments and advanced directives according to department guidelines.
• Assist in documentation of non-compliance for processing of health plan notification.
• Comply with CCM on-call guidelines.
• Comply with hospital visit expectations.
• Follow and adhere to HDMG's standard of attendance policy, as it is essential that the case manager is available to their high-risk patients to coordinate and ensure optimal efficient delivery of care.
• Perform other duties as assigned.

The pay range for this position at commencement of employment is expected to be between $31.76 $42.33/hour, non-exempt; however, base pay offered may vary depending on multiple individualized factors, including market location, job-related knowledge, skills, and experience. The total compensation package for this position may also include other elements, including a sign-on bonus, restricted stock units, and discretionary awards in addition to a full range of medical, financial, and/or other benefits (including 401(k) eligibility and various paid time off benefits, such as vacation, sick time, and parental leave), dependent on the position offered. Details of participation in these benefit plans will be provided if an employee receives an offer of employment.

If hired, employee will be in an "at-will position" and the Company reserves the right to modify base salary (as well as any other discretionary payment or compensation program) at any time, including for reasons related to individual performance, Company or individual department/team performance, and market factors.

• High school graduate or equivalent.
• Graduate from an accredited Licensed Vocational or Registered Nurse Program.
• Current LVN or RN license.
• Current BLS and/or ACLS certification.
• Minimum one year experience as a Case Manager, Acute Care or Skilled Care or equivalent.
• Minimum two years clinical nursing experience (Acute Care, Skilled Care, CM or IM medical office location).
• Experience with Microsoft Office Suite.
• Experience with electronic medical records preferred.
• Excellent written and verbal communication skills.
• Ability to handle and prioritize tasks in order to meet all given deadlines and productivity goals.
• Ability to responsibly handle matters of a confidential nature.
• Ability to work in a multi-task, high-productive environment.