RN Care Manager

Alternate Solutions Health Network

2d•$70,000 - $70,000•Remote

About The Position

Our culture and people are what set us apart from other post-acute care providers. We’re dedicated to the growth and development of our team to set them up for success. We CARE for our patients like they are our own FAMILY. LOCATION: Fully Remote with provided equipment SCHEDULE: 5 days a week 8:15am - 5:00pm, Monday - Friday with a rotating weekend commitment SCHEDULE: Annual Compensation of $70,000 SUMMARY: The RN Care Manager is responsible for the development, oversight and continuity of the patient plan of care, serving as the liaison for collaboration and communication with the field staff. The RN Care Manager will participate in the interdisciplinary team meetings to ensure tight collaboration and appropriate care planning and delivery. This role will manage health care costs by influencing patient care decisions for value-based care delivery, visit type, frequency and calendar plotting cadence based on medical necessity review and utilization management guidelines. The RN Care Manager will assess for real time patient clinical, functional and behavioral health status to ensure rapid follow up, and allocation of services. The RN Care Manager will work alongside branch operations to ensure a holistic approach to patient care. The RN Care Manager will be integral in contributing to the development of new and / or revised work processes, policies and procedures relating to the ASHN Care Management Program. This job description is not designed to cover or contain a comprehensive listing of activities, duties or responsibilities that are required of the employee. Duties, responsibilities and activities may change or new ones may be assigned at any time with or without notice. We are an Equal Opportunity Employer. Alternate Solutions Health Network collaborates with health systems in joint venture partnerships to create a post-acute care solution to deliver efficient centralized operations that is patient focused. Our company has been dedicated, since the very beginning, to transforming the quality of care for our team and our patients.

Requirements

Registered Nurse licensure required
Strong clinical acumen to thoroughly understand the patient’s health and functional status and foster effective communication
Able to create positive impressions and communicate effectively with a variety of people and personalities
Is an active listener and demonstrates ability to engage care team in the patient plan of care
Must project a professional image during virtual communication
Ability to set up work systems and engage in flexible problem-solving behavior
Observant and detail oriented
Proficient in Microsoft Office including Excel, Outlook, Power Point and Word

Nice To Haves

Two years home care field experience preferred
One-year clinical review preferred
Two years case management and/or utilization management experience preferred
Demonstrates exceptional collaboration skills
Self-starter and innovative problem solver
Proficiency in HCHB preferred
Knowledge of Medicare, Medicaid and all State/Federal guidelines for compliance of patient clinical care

Responsibilities

Plan of Care (POC) review and revision to reflect accuracy and regulatory standards
Recertification/Discharge review and recommendation
Utilization/Calendar Management
Adhere to Utilization Management Guidelines
Participate in Interdisciplinary Team Meetings and Agency Townhall Meetings
Seek opportunities to contain cost
Review Charts to monitor compliance with regulatory and governmental regulations
Meets productivity standards and workflow expectations
Functions as a resource for clinicians, agency staff, and internal staff
Collaborates with clinicians as necessary for documentation clarification or educational opportunities
Attends in-service trainings and mandatory agency meetings
Stays current with CMS guidelines and Oasis Guidelines
Read and adhere to all Agency Policies and Procedures and follow Employee Handbook Guidelines
Completes and submits all required documentation within specified company requirements
Other duties as assigned