Care Manager

Job ResponsibilitiesDaily review of Hospital and Skill Nursing Home inpatient listCase Review forms to UM / Quality Department by 4:00 PM New admissionsDaily updates from Hospital and/or SNH Case ManagersTo provide information to Hospital and/or SNH Case ManagerTo coordinate post in patient admission services and office follow upTo obtain medical records from Hospital and/or SNH for office follow upFamily dynamics and support systemsCoordinate with PCP and Care Team at Facilities any possible admissions and/or ER diversions to a Skilled Nursing HomeNotify Skilled Nursing Home admitting physician and Case Manager of any possible admissions and provide medical information as neededMaintain appropriate documentation in available systems EMR and any other CM softwareContact high risk patients when they are no showsDocument in the chart the reason and rescheduleRegular interaction with office Care Team to review elective/future inpatient and outpatient proceduresReview w/ PCPReview Pre-op clearance w/ office staffNotify UM/Quality Department Director of upcoming inpatient proceduresReview all out of the area admissions and keep a daily reportNotify Medical Economics/ Data Department of all out of area admissionsDaily review of office schedules to identify any patients that need Case Management interventionRecent Hospital/SNH dischargesDisease ManagementEducation on Advanced Directives, Community Services informationCase Management SystemMaintain most current patients' informationTracking system for Hospital/SNH admissions and Disease managementTo identify patients for Disease Management and follow up according to protocolCAD/CHF/COPD/DM/CKD Disease ManagementNew patient orientation: All HMO Managed Care Advantage new members orientation within the 1st month of enrollmentCompletion of: Mini Mental, ADLs screening, psychosocial assessment (See new patient orientation form)Identification of any transfer for cause members or reallocation casesTo maintain monthly logsJob QualificationsCurrent Registered NurseCase Manager will work towards and maintain Case Management CertificationCase Manager will maintain continuing education appropriate for case management and professional licensureCPR/BLS certificationBenefitsComprehensive benefits package, including Health, Vision, Dental, and Life insurancesFSA and Life Assistance Program (EAP)401(k) Retirement PlanHealth Advocacy, Travel Assistance, and My Secure AdvantagePTO Accrual and Holidays