The Case Manager provides ongoing outreach and focused care management services for a diverse population of high priority, complex patients. Individualized patient education around disease prevention, chronic disease management, care transitions, and health plan benefits is provided. This position works collaboratively as a member of an interdisciplinary team of professionals responsible for optimizing the patient care plan. Develops effective relationships with in-network, out-of-network practices and care team members to improve care coordination and patient outcomes. Accountable for achieving productivity, quality, and cost containment targets.
Coordinates patient care and resource needs to facilitate care transitions and prevent readmissions and Emergency Department visits.
Serves as a patient advocate, supporting shared decision making and the use of decision aids. Utilizes population management data and resources to identify at risk patients, provide education and remove barriers to care plan compliance.
Establishes effective working relationships with in network and out of network providers and care team members to facilitate improved patient outcomes.
Educates patients and families on a variety of topics, including health plan benefits, navigating the health care system, disease prevention and maintenance and self-management goals. Reviews and monitors patient outcome data, and works collaboratively with an interdisciplinary team to optimize the patient care plan.
Appropriately documents consults and interventions in the patient's electronic medical record.
Actively participates in meetings, problem solving, goal setting, performance improvement and patient satisfaction initiatives.
Identifies barriers to efficient and effective care management and escalates as needed.
Maintains compliance with organizational policies and procedures and evidenced based guidelines.
Work from home option available after completion of initial 90 days and quality metrics achieved and maintained.
Employees eligible for $5,000.00 Recruitment Bonus based on meeting productivity targets.