About Job
Managing a case load for healthcare members with long term care needs.
Monthly and quarterly member contact and will include 80% travel. Remote role. Will require a driver's license.
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.
Registered Nurse License and 2+ years of care management experience, Licenses/Certifications: Valid driver's license Required Skills/Experience: Preferred Skills/ Experience: Physical Health background
1. 2+ years of Care Management experience 1. Home health
2. Experience with electronic medical health records 2. Long term care
3. Microsoft office 3. Discharge planning
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