Care Manager Home First

PruittHealth • Albany, GA

4d

About The Position

The Care Manager Home First screens appropriate referrals and coordinates the admission process, services with providers, billing reconciliation, and outreach to community referral sources. The role supports members through assessments, care coordination, monitoring service effectiveness, and communication with healthcare providers and regulatory agencies. The Care Manager uses a personal vehicle for work-related travel and may participate in an on-call rotation for designated CMS referrals.

Requirements

• At least five years of experience.
• Valid driver’s license and automobile liability insurance.
• Certification in Basic Cardiopulmonary Resuscitation.

Nice To Haves

• Hospice or SOURCE care experience is preferred.

Responsibilities

• Promote awareness of SOURCE and attend PRN meetings with new PCPs in the assigned area.
• Complete new-admission paperwork, obtain signed forms, and conduct in-home assessments.
• Participate in weekly team meetings with the Medical Director and present new admissions, annual assessments, hospitalizations, Home Health admissions and discharges, repeat variances, potential and actual discharges, and situations that threaten a member’s health or functional status.
• Complete quarterly home visits and quarterly PCP visits, including all required documentation and activities.
• Complete variances when care-path goals are not met, document action plans, and follow up through resolution or document a repeat variance with a new plan.
• Track hospital and emergency-room visits by completing paperwork, requesting records, and communicating with hospitals.
• Coordinate with outpatient therapy centers, home health agencies, healthcare centers for short-term care, and rehabilitation providers; work with their staff and complete skilled-care tracking forms.
• Make PRN contacts and home visits as needed to assess member needs.
• Reevaluate member needs and service levels, and assess service effectiveness.
• Use a personal vehicle for travel; complete mileage and time sheets for reimbursement.
• Arrange transportation as required.
• Be available for internal record audits as requested.
• Complete annual reassessments in members’ homes and review medications for appropriateness.
• Attend required trainings and train new hires as needed.
• Participate in the on-call rotation as designated for CMS referrals.
• Communicate with regulatory agencies and DFACS for APS and CPS referrals.

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Education Level: No Education Listed