This position will be working from home and the employee must be licensed and located in NC, GA, or FL
Program Overview
Help us elevate our patient care to a whole new level! Join our Community Care team as an industry leader in serving our members by utilizing best-in-class operating and clinical models. You can have life-changing impact on our Community Care members.
Community Care is a member centric, team-delivered, community-based care management model that joins members where they are.
With compassionate attention and excellent communication, we collaborate with members, providers, and community organizations to address the full continuum of our members’ health care and social determinant needs. Join us in this exciting opportunity as we grow and expand to change lives in new markets across the country.
Acts as a liaison with member/client /family, employer, provider(s), insurance companies, and healthcare personnel as appropriate.
• Implements and coordinates all case management activities relating to catastrophic cases and chronically ill members/clients across the continuum of care that can include consultant referrals, home care visits, the use of community resources, and alternative levels of care.
• Interacts with members/clients telephonically or in person. May be required to meet with members/clients in their homes, worksites, or physician’s office to provide ongoing case management services.
• Assesses and analyzes injured, acute, or chronically ill members/clients medical and/or vocational status; develops a plan of care to facilitate the member/client’s appropriate condition management to optimize wellness and medical outcomes, aid timely return to work or optimal functioning, and determination of eligibility for benefits as appropriate.
Requirements
- including MS Word
- Proficiency with standard corporate software applications
- Ability to work independently (may require working from home).
- and interpersonal skills
- organizational
- Effective communications
- Excellent analytical and problem-solving skills
- Bilingual preferred
- Ability to occasionally travel within a designated geographic area for in-person case management activities as directed by Leadership and/or as business needs arise
- discharge planning and/or home health care coordination experience
- Minimum 2-3 years CM
- cardiac) with Medicare members.
- Excel
- palliative care
- post-acute care
- CKD
- CHF
- Minimum 3-5 years clinical practical experience preference: (diabetes
- hospice
- Outlook and PowerPoint
- Efficient and Effective computer skills including navigating multiple systems and keyboarding
- as well as some special proprietary applications.
- but not required
- or CCM) is preferred
- COHN
- CRRN
- CDMS
- Additional national professional certification (CRC
- Certified Case Manager is preferred.
- state licensing laws may apply
- applicant would be required to obtain a bachelor’s degree within 3-5 years as part of role development
- Associates degree with equivalent experience