Licensed Care Manager Home First Macon

PruittHealth • Macon, GA

8d

About The Position

The Licensed Care Manager screens appropriate referrals and coordinates the admission process. The role coordinates services with providers, reconciles billing, and conducts outreach to community referral sources. The Care Manager supports members through assessments, care coordination, service evaluation, and communication with healthcare providers and regulatory agencies. The position requires travel using the employee’s own vehicle, completion of mileage and time sheets for reimbursement, and participation in an on-call rotation as designated by CMS referrals.

Requirements

• Valid driver’s license.
• Automobile liability insurance.
• Certification in Basic Cardiopulmonary Resuscitation.

Responsibilities

• Market the assigned area to raise awareness of SOURCE and arrange PRN meetings with new primary care providers.
• Complete admission paperwork, obtain signed forms, and conduct in-home assessments.
• Attend 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 threatening a member’s health or functional status.
• Complete quarterly home visits and quarterly primary care provider visits, including all required documentation.
• Complete variances when care-path goals are not met, documenting action plans and following up through resolution or 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, and rehabilitation providers; communicate with their staff and complete skilled care track 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; 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 by CMS referrals.
• Communicate with regulatory agencies and DFACS regarding APS and CPS referrals.

What This Job Offers

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