Job Responsibilities Daily review of Hospital and Skill Nursing Home inpatient list Case Review forms to UM / Quality Department by 4 :
- 00 PM New admissions Daily updates from Hospital and / or SNH Case Managers To provide information to Hospital and / or SNH Case Manager To coordinate post in patient admission services and office follow up To obtain medical records from Hospital and / or SNH for office follow up Family dynamics and support systems Coordinate with PCP and Care Team at Facilities any possible admissions and / or ER diversions to a Skilled Nursing Home Notify Skilled Nursing Home admitting physician and Case Manager of any possible admissions and provide medical information as needed Maintain appropriate documentation in available systems EMR and any other CM software Contact high risk patients when they are no shows.
- Document in the chart the reason and reschedule Regular interaction with office Care Team to review elective / future inpatient and outpatient procedures.
- Review w / PCP Review Pre-op clearance w / office staff Notify UM / Quality Department Director of upcoming inpatient procedures Review all out of the area admissions and keep a daily report Notify Medical Economics / Data Department of all out of area admissions Daily review of office schedules to identify any patients that need Case Management intervention.
Recent Hospital / SNH discharges Disease Management Education on Advanced Directives, Community Services information Case Management System Maintain most current patients’ information Tracking system for Hospital / SNH admissions and Disease management To identify patients for Disease Management and follow up according to protocol CAD / CHF / COPD / DM / CKD Disease Management New patient orientation :
All HMO Managed Care Advantage new members orientation within the 1st month of enrollment Completion of : Mini Mental, ADLs screening, psychosocial assessment (See new patient orientation form) Identification of any transfer for cause members or reallocation cases To maintain monthly logs Job Qualifications Current Registered Nurse Case Manager will work towards and maintain Case Management Certification Case Manager will maintain continuing education appropriate for case management and professional licensure CPR / BLS certification BENEFITS Comprehensive benefits package, including Health, Vision, Dental, and Life insurances FSA and Life Assistance Program (EAP) 401(k) Retirement Plan Health Advocacy, Travel Assistance, and My Secure Advantage PTO Accrual and Holidays #ZIP #INDNP #LI-SW1 Powered by JazzHR