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    Telephonic RN Care Manager for ComplexCare Solutions, Inc. in Connecticut

    Some responsibilities include:

    Job Description:

    – Performs care management as trained by ComplexCare Solutions.
    – Identifies and acts upon barriers to care by using appropriate community and CCS resources including but not limited to, social workers, DME, Homecare etc…
    – Reduces hospitalization and readmission rates by utilizing care management
    – Follows CCS policies & procedures and best practices including but not limited to:
    – Documentation-Assessments and reassessments of body systems, environment, social, behavioral, financial and functional abilities
    – Discharge planning
    – Productivity standards: CM will connect with 8 members a day
    – PHV visits within 48-72 hours of discharge
    – Responsible for enrollment assessments of assigned patients that includes evaluation of physiological, psychosocial, environmental, financial, and health-related behavior domains
    – Establishes a plan of care with patients, providers, and payers that identifies and continuously reassesses cost-efficient appropriate levels of care
    – Enhances communication and collaborative relationships with multidisciplinary healthcare team members
    – Emphasizes continuity of care, thus reducing or eliminating fragmentation, duplication, and gaps in treatment plan
    – Acts as a patient advocate protecting privacy and confidentiality issues
    – Provides patient education, monitoring of health needs, and coordination of community resources
    – Prevents adverse patient occurrences when possible and intervenes quickly if prevention is not possible, thereby minimizing poor outcomes
    – Facilitates patient empowerment and quality of life by promoting educated, independent patient choice on all aspects of care
    – Collects quality review data to support outcome measurements
    – Maintains a comprehensive working knowledge of community resources, payer requirements, and network services for target population
    – Identifies opportunities for health promotion and illness prevention
    – Demonstrates accountability for own professional practice by participating in educational programs that increase case management knowledge base and skill set
    – Participates in practice case studies

    Education/Experience Requirements:

    – Registered Nurse with current state licensure
    – Minimum of 5 years of experience in a case management, clinical or discharge planning role – one year minimum experience in case management preferred
    – Experience with Medicare/Medicaid Skilled visits within last year
    – Strong professional level of knowledge and experience in the adult population and chronic disease management
    – Maintains current CPR certification
    – Valid Driver License
    – OASIS experience preferred within last year
    – Homecare experience required


    Apply now. Jobs go fast!

    Posted by vwah012015 @ 9:49 pm

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