Job Listing: Telephonic RN Care Manager
Company: ComplexCare Solutions, Inc.
Location: Connecticut
Job Description:
The Telephonic RN Care Manager will be responsible for the following duties:
- Care Management: Perform care management as trained by ComplexCare Solutions.
- Barrier Identification: Identify and act upon barriers to care using appropriate community and CCS resources, including social workers, DME, homecare, etc.
- Hospitalization Reduction: Utilize care management to reduce hospitalization and readmission rates.
- Adherence to Policies: Follow CCS policies & procedures and best practices, including:
- Documentation: Assessments and reassessments of body systems, environment, social, behavioral, financial, and functional abilities.
- Discharge Planning: Develop and implement discharge plans.
- Productivity Standards: Connect with 8 members a day.
- PHV Visits: Conduct visits within 48-72 hours of discharge.
- Enrollment Assessments: Conduct enrollment assessments of assigned patients, including evaluation of physiological, psychosocial, environmental, financial, and health-related behavior domains.
- Care Planning: Establish a plan of care with patients, providers, and payers, continuously reassessing cost-efficient and appropriate levels of care.
- Team Collaboration: Enhance communication and collaborative relationships with multidisciplinary healthcare team members.
- Continuity of Care: Emphasize continuity of care to reduce or eliminate fragmentation, duplication, and gaps in the treatment plan.
- Patient Advocacy: Act as a patient advocate, protecting privacy and confidentiality issues.
- Patient Education: Provide patient education, monitor health needs, and coordinate community resources.
- Risk Prevention: Prevent adverse patient occurrences when possible and intervene quickly to minimize poor outcomes.
- Patient Empowerment: Facilitate patient empowerment and quality of life by promoting educated, independent patient choice on all aspects of care.
- Quality Review: Collect quality review data to support outcome measurements.
- Resource Knowledge: Maintain a comprehensive working knowledge of community resources, payer requirements, and network services for the target population.
- Health Promotion: Identify opportunities for health promotion and illness prevention.
- Professional Development: Demonstrate accountability for professional practice by participating in educational programs to increase case management knowledge base and skill set.
- Case Studies: Participate in practice case studies.
Education/Experience Requirements:
- Licensure: Registered Nurse with current state licensure.
- Experience: Minimum of 5 years in a case management, clinical, or discharge planning role; at least 1 year in case management preferred.
- Medicare/Medicaid Experience: Experience with Medicare/Medicaid skilled visits within the last year.
- Knowledge: Strong professional knowledge and experience in the adult population and chronic disease management.
- Certification: Current CPR certification.
- Driver License: Valid driver license.
- Preferred Experience: OASIS experience within the last year.
- Homecare: Homecare experience required.
For more details and to apply, visit ComplexCare Solutions.
Apply now. Jobs go fast!