Care Manager, RN

US-OH-Remote
Req No.
2017-2059
Category
Clinical/Medical
Type
Regular Full-Time

Overview

 

 

Concerto delivers comprehensive care to Medicare, Medicaid, and complex-needs patients. For over a decade, we have provided extraordinary outcomes for thousands of people in these underserved groups.

The Concerto name reflects our unique approach to healthcare. It’s about how we work in concert with patients, providers, and health plans. It’s about the harmony of a patient’s care, health, and dignity.

 

Acts as an advocate to Concerto patients. An autonomous role that coordinates and manages tasks/interventions associated with the patient’s care plan. Manages patients by providing high frequency of outbound contacts with patient and/or their responsible party or their caregiver. Works with multi-disciplinary care team to develop interventions/changes to care plan in response to patient’s health care and psycho-social needs

Responsibilities

  • Knowledge of Medicare and Medicaid reporting requirements preferred.
  • Documents patient care plan tasks, goals, and interventions. in Fidelis Care Management System
  • Assist with identification of high risk patients that require a high frequency of care coordination and contact
  • Perform outbound calls to patients approved by the multi-disciplinary team
  • Must document significant specialty and diagnostic services and outcomes in patient care plan.
  • Identifies caregiver training needs and tracks impact of needs and or training
  • Assist with discharge planning/coordination to ensure all post-discharge services required are in place and patient has scheduled post-discharge appointment
  • Identifies the appropriate utilization of resources across the continuum of care
  • Maintains patient/caregiver care plan compliance reporting. Submits reports to interdisciplinary care team weekly.
  • Participates in quality improvement and evaluation processes
  • Coordinates and directs the retrieval of diagnostic results from specialty referrals back to the clinic
  • Works closely with the Pharmacy Benefit Manager and community pharmacies to help coordinate medication accessibility and medication refills.
  • Demonstrates the ability to triage and apply critical thinking skills
  • Ability to work in a fast paced environment; demonstrates ability to perform multiple concurrent tasks with minimal supervision and meets deadlines.
  • Ability to communicate effectively in writing and verbally
  • Must have knowledge of Microsoft Office.
  • Prior UM experience a plus.

Qualifications

  • Current RN License in good standing in the state of practice required.
  • Minimum of 3 years’ experience in an acute care setting as a health care professional in a clinical area

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