Care Management Specialist II
Careers Integrated Resources IncAtlanta, GA, US14 days ago
Job type
- Full-time
Job descriptionDischarge care coordination, episodic case management and pre-admission / post discharge counselling and identification of alternate treatment options. Consult with physicians, coordinators, and facility discharge planners to determine other resources and appropriate disposition of such cases. Provide education, counselling and referral to other resources to minimize re-admissions and emergency room episodes. Perform additional ongoing functions to support the member in the transition of care process including more than one of the following. Consult with physicians, providers, members, and other resources, as appropriate, to assess, plan, facilitate implementation, coordinate, monitor and evaluate options and services required to meet an individual’s acute health needs, using communication and available resources to promote quality health outcomes. Personalize outreach / engagement based upon attitudes / behaviours / risk assessment. Outreach to provider to coordinate the member’s care or to notify of risks / new conditions. Reconcile, educate and monitor adherence to medication safety. Reinforce provider post-operative instructions for care, diet, activity level etc. Address barriers to keeping follow-up appointments with appropriate provider and assistance with appointment scheduling. Assistance finding a primary or specialist provider, a Blue Distinction Center or any needed coordination with Customer Service. Assist with getting to a provider if needed when all other options have been exhausted. Referral to other BCC programs, or external resources? community-based organizations, transportation, home health etc.i. Provide onsite face to face intervention in select cases. Education and recommendations to resolve conditions and risks, and support for behaviour change / self-management. Collaborate with the provider and member when appropriate to develop alternate plans of care if needed. Assist members / providers to navigate the health care system. Assess cases for quality-of-care issues and refer cases to the QA / QI department for review and follow up.n. Perform Transition of Care services for all assigned lines of business. Determine case complexity and may refer to Case Management / Disease Management / Enterprise Lifestyle Management department personnel as necessary. Practice within the Product of licensure. Participate as preceptor for orientation of new employees. Maintain licensure and maintain and enhance knowledge for designated area of licensure and regulatory standards by attending seminars, training sessions, etc. Communicate and interact effectively and professionally with co-workers, management, customers, etc.7. Comply with HIPAA, Diversity Principles, Corporate Integrity, Compliance Program policies and other applicable corporate and departmental policies. Maintain complete confidentiality of company business. Maintain communication with management regarding development within areas of assigned responsibilities and perform special projects as required or requested.
Job Title : Care Management Specialist II
Job Location : Remote + Field Visit, IL (Chicago / Rockford)
Job Duration : 3 months + contract (Possibilities of Extension)
Shift : 8AM to 5PM (Mon-Fri)
Pay Rate : $38 / hr - $39 / hr on W2
Milage will reimburse form client
Job Summary :
- This position is responsible for discharge care coordination, episodic case management and pre-admission / post-discharge counselling for an acute condition.
- This position is responsible for handling duties in an independent manner and may assist other staff.
- Establish relationship with the member through the immediate post discharge follow-up period or until all short-term care needs are met.
- Provide education / local resource information and encourage member (self) education. Determine case complexity and refer to other internal departments as needed.
Essential Functions :
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Care Management Specialist • Atlanta, GA, US
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