ACO Case Manager

divh2Case Manager (ACO)/h2pThe ACO Case Managers will play a vital role in the clinical, financial and education of patients and will ensure these aspects are all considered simultaneously throughout the continuum of care. ACO Case managers will ensure the patient receives the right services at the right level of care and will assist the patient in navigating their own care at an optimum level./pulliCommunicates the ACO Care Coordination process to Beneficiary/family/physicians and other Care Coordination team members explaining beneficiarys right to refuse care coordination (opt-out) and accept (opt-in) as desired and the benefits of the program to the Beneficiary/family/physicians at no cost to the Beneficiary./liliDemonstrates the ability to follow through with requests, sharing of critical information, and getting back to individuals in a timely manner./liliFunctions as liaison between administration, Beneficiaries, physicians and other healthcare providers./liliInteracts professionally with Beneficiary/family/physicians and involves Beneficiary/family/physicians in formation of the plan of care./liliDevelops an outcome-based plan of care, based on the Beneficiarys input and assessed Beneficiary needs. Implements and evaluates the plan of care as often as needed as evidenced by documentation in the Beneficiarys case file with clear and concise Beneficiary focused goals and outcomes./liliDocuments Beneficiary assessment and reassessment, Beneficiary care plans, and other pertinent information completed in the Beneficiarys medical record utilizing critical thinking skills and in accordance with the FOCUS Charting methodology, nursing standards, and company policies and procedures./liliEducates the Beneficiary/caregiver on the transition process and how to reduce unplanned transitions of care./liliIdentifies and addresses psycho-social needs of the beneficiarys, family and facilitates consultations with Social Worker, as necessary./liliResponsible for the coordination and facilitation of Beneficiary and family conferences as determined by assessment of Beneficiarys needs telephonically./liliResponsible for the coordination of post-discharge clinic appointments, medication reconciliation, PCP and SPC visits./liliResponsible for the identifying beneficiaries that are appropriate for hospice conversion or Palliative care, and assist the beneficiaries and/or their families in accomplishing this process if requested./liliDistribution of work: Daily production will vary from day to day. All assigned work must be completed by the end of business day in order to maintain customer service to High Risk patients./liliProtects privacy for both beneficiaries and employees; ensuring all personal health information is kept confidential-complies with HIPPA regulations./liliOther duties as assigned./li/ulpQualifications/pulliGraduate from an accredited Registered Nursing Program or Licensed Vocational Nursing Program./liliCurrent CA RN, or LVN license, valid CA Drivers license./lili3 years acute care or care management experience./liliTyping 40 words per minutes with accuracy./liliKnowledge of computers, faxes, printers and all other office equipment./liliKnowledgeable in MS Office Programs (i.e., Word, Excel, Outlook, Access and PowerPoint)/liliPossible on call duties as assigned./li/ulpCare Navigators On Demand is an Equal Opportunity Employer and does not discriminate on the basis of race or ethnicity, religion, sex, national origin, age, veteran disability or genetic information or any other reason prohibited by law in employment./p/div

Care Navigators On Demand