Licensed Care Manager Alpharetta & Suwanee

PruittHealth•Norcross, GA

4d•Onsite

About The Position

This position is responsible for screening appropriate referrals, coordinating the admission process, and managing services with providers. The role also involves billing reconciliation and community outreach to referral sources. The Licensed Care Manager will market their area to raise awareness of SOURCE and PRN meetings with new PCPs, complete all new admission paperwork including signed forms and in-home assessments, and participate in weekly team meetings with the Medical Director to present various case updates such as new admits, annual assessments, hospitalizations, Home Health admits and discharges, repeat variances, potential discharges, actual discharges, and situations threatening health or functional status. The role requires completing quarterly home visits and PCP visits, documenting variances when care path goals are not met with outlined plans and follow-ups, and tracking all hospital/ER visits. Coordination with outpatient therapy centers, home health agencies, healthcare centers, and rehab facilities is essential, along with making PRN contacts and home visits as needed to assess member needs, reevaluate service levels, and evaluate service effectiveness. The position requires using a personal vehicle for travel, completing mileage and time sheets, arranging transportation, being available for internal record audits, completing annual reassessments in member homes, and reviewing medicine for appropriateness. Additionally, the role involves attending required trainings, training new hires, participating in on-call rotations for CMS referrals, and communicating with regulatory and DFACS agencies for APS and CPS referrals.

Requirements

Current State License as a Licensed Practical Nurse, LPN
Must have a valid driver’s license and automobile insurance liability
Graduate of a state approved accredited nursing school
Certified in Basic Cardiopulmonary Resuscitation
Minimum of five (5) years of nursing experience.

Nice To Haves

Hospice or SOURCE care preferred.

Responsibilities

Markets their area for awareness of SOURCE and PRN meetings with new PCPs.
Completes all new admission paperwork for signed forms and in-home assessments.
Participates in team meetings with Medical Director each week and presents all new admits, annual assessments, hospitalizations, Home Health admits and discharges, repeat variances, People with potential for discharge and actual discharges and situations threatening someone’s health or functional status.
Completes quarterly homes visits and quarterly PCP visits with all requirements for each completed.
Completes variances at any given time when a care path goal is not met. Must list the variance plan of actions and must have follow up to resolution or a repeat variance with a new plan outlined.
Tracks all hospital/ER visits by completing paperwork, requesting records and communicating with hospitals.
Coordinates with outpatient therapy centers, home health agencies, healthcare centers (if short term), and rehab by working with their staff and completing skilled care track form.
Makes PRN contacts and home visits if needed to assess member needs.
Reevaluates member needs for service, level of service and evaluates service effectiveness.
Uses own vehicle for travel.
Completes mileage and time sheets for reimbursement.
Arranges transportation as required.
Is available for internal record audits as requested.
Completes annual reassessments in member’s homes.
Reviews medicine for appropriateness.
Attends trainings when required.
Trains new hires as needed.
Is available for on-call rotation as designated by CMS referrals.
Communicates with regulatory and DFACS agencies for APS and CPS referrals.