Patient Care Manager for Hospital at Home Program On-Site

Job Location : Command Center at the Columbia Hospital, the Cornell Hospital or the centralized hospital at home Command Center near the Cornell campus.

Shift : 7am-5pm

Job Purpose :

As a Patient Care Manager, you will be at the forefront of our innovative Hospital at Home ("HaH") care model that allows patients who are clinically appropriate to have the option to receive acute care in the comfort of their own homes in lieu of an inpatient hospital setting. As a Patient Care Manager, you will be fully integrated into the clinical teams at our health system partner, working directly with patients as well as the clinical teams on the floor of the hospital and telephonically from an office setting.

This role offers the unique opportunity to work directly with the patient and their providers to not only coordinate the patient's recovery from the acute illness, but also to develop the deep relationships with patients needed to successfully engage them with the resources they will need to improve their health and quality of life.

As a Patient Care Manager, you will leverage our technology suite as well as our interdisciplinary network of doctors, nurses, pharmacists, and ancillary service providers to improve the health and well-being of patients and ease the burden on caretakers.

Job Duties :

• Manages patient requests, telephonically or through our technology platform, to coordinate the appropriate care and bring it to the attention of the providers as needed.
• Works with partner physicians to educate patients on the HaH Care model; provides education regarding use of the telehealth system and processes.
• Manages Hospital at Home tools and technology, ensuring systems are properly set up prior to a patient's admission. Also responsible for tracking and ordering inventory as needed.
• Works with our partner's providers to confirm admission health and home assessment data collection is accurate, ensuring the home environment is safe.
• Builds and maintains collaborative professional working relationships with physicians, Medical Directors, clinicians, and the community at large to develop and implement a successful cross-continuum care management process.
• Follows clinical and operational workflows.
• Maintains all required documentation in all interactions with our health systems' patients and the care team.
• Watches for trends and hurdles involved in health care system and incorporates operational solutions for system challenges, including patient, family and physician responses into an evolving process and model that increases quality and satisfaction- patient or physician.
• Communicates discharge information to other clinical departments or members of the Care Team.
• Generates operational quality reports and presents updates to our partners' physicians and nurses.
• Assists as needed in recruiting, client and community outreach and critical incident / complaint management.

Experience / Education :

Required Skills :

Employment Type :

Salaried employee + bonus

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