Manages chronically ill patients through the health care system by assisting with access issues, developing relationships with service providers, and tracking interventions and outcomes. Supervises and evaluates the nurse liaisons in formulating and implementing a homecare plan; implements policies and procedures of the home care network. Interprets regulatory guidelines for admission to Home Care; collaborates with home care agency and subacute discharge planning staff. Assists with the ongoing promotion of the Home Care Network. Provides direct services to patients including the completion of needs assessments, development of patient focused care plans, periodic reassessments and overall comprehensive service coordination. Advocates the requirements of clients within the agency and with external service providers. Assists providers, medical assistants, nurses, behavioral health providers, social workers, etc. by coordinating all aspect of care inclusive of appointments, referrals, adherence, specialty care, etc. Acts as the primary channel transmission of information between providers and patients. Performs related duties as required. All responsibilities noted here are considered essential functions of the job under the Americans with Disabilities Act. Duties not mentioned here, but considered related are not essential functions.
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Job Type
Full-time
Career Level
Manager
Number of Employees
5,001-10,000 employees