Licensed Care Manager Home First
About The Position
The Licensed Care Manager screens appropriate referrals and coordinates the admission process, services with providers, and billing reconciliation. The role also conducts outreach to community referral sources and promotes awareness of SOURCE through meetings with new primary care providers. The Care Manager completes admission paperwork and in-home assessments, participates in weekly team meetings with the Medical Director, conducts quarterly home and PCP visits, and completes annual reassessments in members’ homes. The position tracks hospital and emergency-room visits, coordinates with healthcare and therapy providers, evaluates member needs and service effectiveness, reviews medications, and responds to situations that may threaten a member’s health or functional status. The position requires travel using a personal vehicle, completion of mileage and time sheets for reimbursement, and arranging transportation when needed. The Care Manager may be asked to support record audits, attend training, train new hires, participate in an on-call rotation for designated CMS referrals, and communicate with regulatory and DFACS agencies regarding APS and CPS referrals.
Requirements
- Current state license as a Licensed Practical Nurse (LPN).
- Valid driver’s license and automobile liability insurance.
- Graduate of a state-approved accredited nursing school.
- Certification in Basic Cardiopulmonary Resuscitation (CPR).
- Minimum of five years of nursing experience.
Nice To Haves
- Hospice or SOURCE care experience.
Responsibilities
- Screen appropriate referrals and coordinate the admission process.
- Coordinate services with providers and reconcile billing.
- Conduct outreach to community referral sources and promote SOURCE awareness through meetings with new PCPs.
- Complete new-admission paperwork, obtain signed forms, and conduct in-home assessments.
- Participate in weekly team meetings with the Medical Director and present updates on new admissions, annual assessments, hospitalizations, home health admissions and discharges, repeat variances, potential and actual discharges, and situations threatening members’ health or functional status.
- Complete quarterly home visits and quarterly PCP visits, including all required documentation.
- Document variances when care-path goals are not met, outline action plans, follow up through resolution, and create a new plan for repeat variances.
- 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 members’ service needs and level of service, and evaluate service effectiveness.
- Use a personal vehicle for travel; complete mileage and time sheets for reimbursement; and 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 training and train new hires as needed.
- Participate in the on-call rotation as designated for CMS referrals.
- Communicate with regulatory and DFACS agencies regarding APS and CPS referrals.
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What This Job Offers
Job Type
Full-time
Career Level
Mid Level
Education Level
No Education Listed
