Care Management Specialist- PRNRequisition R079337 Market Richmond, Virginia Department SS Quality - Care Management Shift Days Schedule Part-time
Thank you for considering a career at Bon Secours!
PRIMARY FUNCTION/GENERAL PURPOSE OF POSITION:
The Care Management Specialist serves as a support and a partner with the Care Managers on patient care areas by improving the efficiency of the entire Care Management Team.
EMPLOYMENT QUALIFICATIONS: High School Graduate or equivalent. Prefer some college/business school. Experience in a medical office, hospital department setting or with a health insurance company preferred. Ability to communicate pertinent medical information via knowledge of medical terminology preferred. Knowledge of various software applications, i.e., Microsoft Office, including Excel and PowerPoint preferred. Excellent communication, customer service, interpersonal and organizational skills. Must be able to work under considerable stress, using tact and diplomacy. Must demonstrate an ability to work independently, problem solve, and be able to resolve conflict in an assertive manner.
Meet with patients who do not have a Primary Care Physician (PCP) to present and discuss Bon Secours PCP options for the patient or PCP of patient choice.
Calls and schedules all follow up appointments with PCP, Specialty Physicians, wound clinic, OPIC, free clinics in area and then documents on a patient’s After Visit Summary for continuity of care. Faxes Clinical information to PCP when needed.
Patient Placement Support
Ensure that timely referrals are made to post discharge facilities and services to enhance the continuum of care for the patient, avoid discharge delays and ensure appropriate length of stay for patient. Pro-actively coordinate with LTAC, Sub-acute, SNF/ICF, Assisted Living, Psych facilities, Veteran Affairs, Workers Comp, and Group Home placement by calling facilities directly to expedite the transfer. Utilizing Allscripts/Navi Health discharge planning platform, Connect Care CC Link to provide clinical and demographic information to designated facilities observing all the guidelines associated with HIPAA requirements. Coordinates with Resource Center to obtain any authorizations to facilitate transfer. Receive and communicate to Care Managers the outcome of facility referral. Route responses from facilities to appropriate Care Managers for action. Effectively documents progress in required systems to include final facility disposition with level of care.
Coordinates Home Health/Hospice Referrals
Notify Home Health/Hospice agencies of referral after Freedom of Choice (FOC) obtained by Care Manager. Arrange DME/oxygen after FOC obtained by Care Manager if no home health agency.
Initiates telephonic contact within 48 hours of discharge to high risk patients to determine discharge plan effectiveness. Documents patient/family responses and referral to other staff member for additional intervention on the Discharge Plan. Documentation is of the call and response is added to the DC Plan in Care Planning Manager and a copy is sent to HIMs for addition to the patient’s medical record.
May be asked to complete the electronic UAI (Uniform Assessment Instrument) submissions for the facility assigned with proper training. Ensures facilities receive completed UAI when needed. Utilize Connect Care in support of the Care Manager. Delivers and explains the follow-up IMM letters (Important Message from Medicare) to patients within 48 hours of discharge. Delivers and explains Observation Status notifications to all patients in an observation status between 24 and 36 hours of admission. Deliver Code 44 Letters as may be required. Assist the care manager with discharge appeals. Assists in organizing and maintaining Durable Medical Equipment for the office. Delivers Durable Medical Equipment to patients and submits documentation to company. Maintains accurate excel log of Last Resort Fund and patients that have been helped previously. Clerical tasks as needed such as mail sending/pickup, census updating, fridge temp monitoring, sending Physician list to VUR team. Maintains and updates on call calendars and Team Shared site as needed. Assists with ordering tools and supplies for office. Attend monthly meetings, in services, and completes Health stream and other educational training as mandated.
Documents work with patients through appropriate record keeping that follows policies and procedures. Utilizes all software and other computerized applications effectively. Makes referrals for needed services and facilitates access to community resources. Use of SMS, A4, Allscripts or Navi Health, ConnectCare, and other software systems. Follows infection control guidelines.
Bon Secoursis an equal opportunity employer.
We’ll also reward your hard work with:
- Comprehensive, affordable medical, dental and vision plans
- Prescription drug coverage
- Flexible spending accounts
- Life insurance w/AD&D
- An employer-matched 403(b) for those who qualify
- Paid time off
- Educational Assistance
- And much more
Scheduled Weekly Hours:0.01
Department:SS Quality - Care Management
All applicants will receive consideration for employment without regard to race, color, national origin, religion, sex, sexual orientation, gender identity, age, genetic information, or protected veteran status, and will not be discriminated against on the basis of disability. If you’d like to view a copy of the affirmative action plan or policy statement for Mercy Health – Youngstown, Ohio or Bon Secours – Franklin, Virginia; Petersburg, Virginia; and Emporia, Virginia, which are Affirmative Action and Equal Opportunity Employers, please email firstname.lastname@example.org. If you are an individual with a disability and would like to request a reasonable accommodation as part of the employment selection process, please contact The Talent Acquisition Team at email@example.com.
I wanted to get into a career where I’m happy to go to work.Luis F. Registered Nurse