About Job
- 8-5 Mon-Fri; Monthly and quarterly member contact and will include 80% travel. Remote role.
- Will require a driver's license.
- - Managing a case load for healthcare members with long term care needs.
- - Geriatric long term care - Member assessments and notes.
- - Complete assessments with members, caregivers, or providers to obtain information regarding client status, support system, and need for services for care plan development.
- - Monitor delivery of services and follow-up with members, caregivers, or provider s through in person visits and telephonic contact.
- - Authorize and coordinate referral for services.
- - Ensure provider services are delivered without gaps and identify functional deficiencies in plans of care.
- - Assist in coordinating the development of informal or voluntary services to integrate into the member care plan Collaborate with discharge planners, physicians, and other parties to ensure appropriate discharge plan, care plan, and coordination of acute care and long-term care services!
- - Assist member with filing and resolving complaints and appeals.
- Technology Savy (Must be able to look at calendar and manage time - ensuring enough time for documentation)
- 2+ years of Care Management experience (field experience is a must)
- Caseloads of 50,60,70 members who are 65 years of age and above team is not looking for pediatric experience.
- Long Term Care Medicaid experience.
- Medicaid / Medicare experience.
- Need to see experience being able to manage high case load.
- Each member must be contacted once per month, and some may need to be seen.
- Fast paced environment regarding new processes and programs.
- They must be comfortable being able to connect with IT should their equipment fail in the field, etc. or be able to go into an office location or IT space.
- All documentation must be within system within 24 hours of completion.
- Experience with electronic medical health records.
- Home Health3Experience
- Nice to haves: 1. Discharge Planning
- Disqualifiers: - Not having field experience - Not having previous experience with high caseloads Performance indicators:
- Bilingual always preferred - req will indicate if Bilingual is required via the notes section
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