What are the responsibilities and job description for the Care Manager position at MyCare Medical Group?
Job Responsibilities
- Daily review of Hospital and Skill Nursing Home inpatient list
- Case Review forms to UM / Quality Department by 4:00 PM New admissions
- Daily updates from Hospital and/or SNH Case Managers
- To provide information to Hospital and/or SNH Case Manager
- To coordinate post in patient admission services and office follow up
- To obtain medical records from Hospital and/or SNH for office follow up
- Family dynamics and support systems
- Coordinate with PCP and Care Team at Facilities any possible admissions and/or ER diversions to a Skilled Nursing Home
- Notify Skilled Nursing Home admitting physician and Case Manager of any possible admissions and provide medical information as needed
- Maintain appropriate documentation in available systems EMR and any other CM software
- Contact high risk patients when they are no shows.
- Document in the chart the reason and reschedule
- Regular interaction with office Care Team to review elective/future inpatient and outpatient procedures.
- Review w/ PCP
- Review Pre-op clearance w/ office staff
- Notify UM/Quality Department Director of upcoming inpatient procedures
- Review all out of the area admissions and keep a daily report
- Notify Medical Economics/ Data Department of all out of area admissions
- Daily review of office schedules to identify any patients that need Case Management intervention.
- Recent Hospital/SNH discharges
- Disease Management
- Education on Advanced Directives, Community Services information
- Case Management System
- Maintain most current patients’ information
- Tracking system for Hospital/SNH admissions and Disease management
- To identify patients for Disease Management and follow up according to protocol
- CAD/CHF/COPD/DM/CKD Disease Management
- New patient orientation: All HMO Managed Care Advantage new members orientation within the 1st month of enrollment
- Completion of: Mini Mental, ADLs screening, psychosocial assessment (See new patient orientation form)
- Identification of any transfer for cause members or reallocation cases
- To maintain monthly logs
Job Qualifications
- Current Registered Nurse
- Case Manager will work towards and maintain Case Management Certification
- Case Manager will maintain continuing education appropriate for case management and professional licensure
- CPR/BLS certification
BENEFITS
- Comprehensive benefits package, including Health, Vision, Dental, and Life insurances
- FSA and Life Assistance Program (EAP)
- 401(k) Retirement Plan
- Health Advocacy, Travel Assistance, and My Secure Advantage
- PTO Accrual and Holidays
#ZIP
#IND
Salary : $65,000 - $85,000
Pediatric Field Care Manager Nurse
Humana -
Pinellas Park, FL
