Care Manager - Home healthcare

CNSCares•Grand Junction, CO

12d•Hybrid

About The Position

On behalf of CNS Cares, LLC (“CNS” or “Company”), the Care Manager is responsible for overseeing the delivery of coordinated care for a patient and/or an assigned group of patients. Additionally, this position is responsible for maximizing authorization units, advocating for the needs of each patient, communication with all entities to provide quick and accurate service, and ensure patient satisfaction with impeccable service. The employee must have regular attendance/punctuality, be able to work with others at all levels of the Company, have exceptional customer service, and be completely honest. Other assigned duties include demonstrating excellent communication skills, scheduling visits for the care team, identifying patient needs for durable medical equipment, evaluating patient conditions, assisting the authorization team, attending medical appointments with patients, gathering medical records, ensuring authorized units are staffed, providing EMR and home orientation training, and participating in an on-call rotation.

Requirements

High School Diploma and Associates Degree in a related field.
At least two (2) years of experience in healthcare; or equivalent combination of education and EEOICPA experience.
At least two (2) years of staff scheduling experience required.
Knowledge of HIPAA regulations and the ability to maintain strict confidentiality of patient information.
Ability to establish interpersonal relationships with people from diverse socioeconomic and cultural backgrounds.
Able to wear personal protective equipment (e.g., face mask, goggles, latex/non-latex gloves) as needed.
Ability to work effectively within role independently and with other team members.
Ability to organize and complete work in a timely manner.
Ability to understand medical/surgical terminology.
Valid Driver’s License
Criminal background check
Driving Record check
OIG Exclusion List check
Sex Offender Registry check

Nice To Haves

Associate's Degree or Bachelor’s Degree preferred
At least two (2) years of Department of Labor / EEOICPA experience
Home health experience preferred
Ability to travel up to 80% of time in designated territory.

Responsibilities

Demonstrate excellent communication skills. Communicates regularly with patients, nurses, home health aides, and claims team. Communicates with the Executive Director and Director of Nursing on patient status and care being provided in home.
Schedule visits for the care team within the electronic medical record (EMR). Works to find coverage in situations where there is staffing needs. Works with the recruiting team and local leadership to adequately source and hire new staff. Expectation to utilize 100% of authorized hours. Ensures clinical compliance items are scheduled and completed per company and state guidelines.
Identify patient needs for durable medical equipment and coordinate with DME companies to ensure patients’ needs are met.
Evaluate patient conditions not currently covered by the Department of Labor and coordinate and assist patients to get consequential illnesses added to their DOL covered conditions.
Assist authorization team with start of cares and renewal periods to advocate and justify the appropriate care level for each patient.
Attend medical appointments with patient to assist as a resource to physicians regarding the Department of Labor Home Health Care program.
Gather medical records as needed.
Ensure all authorized units are staffed by the assigned skilled nurse or home health aide with expectation to limit overtime. Coordinate with GM and DON for appropriate direction.
Provide EMR and home orientation training to staff.
Participate in an on-call rotation.
Adhere to all company policies.
Other duties as assigned